ABA Emergency Response Procedures 3

Question 1

During cardiopulmonary bypass weaning, the patient develops ventricular fibrillation. After three defibrillation attempts fail, which pharmacologic agent should be given next?

Accepted Answer

Amiodarone 300 mg IV bolus

Answer

Lidocaine 1.5 mg/kg IV

Answer

Magnesium sulfate 1–2 g IV

Answer

Procainamide 17 mg/kg IV

Question 2

A patient develops sudden bronchospasm during general anesthesia. The anesthesiologist increases the inhaled volatile agent, but airway pressures remain above 50 cmH2O. What is the next best intervention?

Accepted Answer

Administer epinephrine 0.1–0.3 mg IV or IM

Answer

Administer ketamine 1–2 mg/kg IV

Answer

Switch to TIVA with propofol infusion

Answer

Administer dexamethasone 8 mg IV

Question 3

A term parturient receiving epidural labor analgesia suddenly seizes and becomes unresponsive with a BP of 50/30. The most likely diagnosis is:

Accepted Answer

Local anesthetic systemic toxicity (LAST)

Answer

Eclampsia

Answer

Anaphylaxis to epidural opioid

Answer

Vasovagal syncope

Question 4

The treatment for local anesthetic systemic toxicity (LAST) with cardiac arrest includes which unique pharmacologic agent?

Accepted Answer

20% Intralipid 1.5 mL/kg IV bolus

Answer

Sodium bicarbonate 1 mEq/kg IV

Answer

Calcium gluconate 1 g IV

Answer

Magnesium sulfate 2 g IV

Question 5

Intraoperatively, a patient on isoflurane develops masseter rigidity, rising ETCO2 of 92 mmHg, and a temperature of 39.8°C. After stopping the triggering agent, which drug is administered first?

Accepted Answer

Dantrolene 2.5 mg/kg IV

Answer

Succinylcholine 1.5 mg/kg IV

Answer

Propofol 2 mg/kg IV

Answer

Sodium bicarbonate 2 mEq/kg IV

Question 6

During an orthopedic procedure with a tourniquet, the patient develops tachycardia, hypotension, and petechiae on the chest and axillae. SpO2 drops to 90%. The most likely cause is:

Accepted Answer

Fat embolism syndrome

Answer

Pulmonary embolism from deep vein thrombosis

Answer

Anaphylaxis to cement

Answer

Tension pneumothorax

Question 7

A patient develops stridor and hives 10 minutes after receiving rocuronium induction. BP is 65/40, HR 130. The initial dose of epinephrine for anaphylaxis in an adult is:

Accepted Answer

0.1 mg (1:10,000) IV titratable

Answer

0.5 mg (1:10,000) IV

Answer

0.3 mg (1:1,000) IM into lateral thigh

Answer

1 mg (1:10,000) IV push