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

Amiodarone 300 mg IV is the preferred antiarrhythmic after failed defibrillation in shock-refractory ventricular fibrillation per ACLS guidelines.

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

Epinephrine is the definitive rescue agent for severe bronchospasm unresponsive to volatiles and beta-agonists, acting on β2 receptors to relieve bronchoconstriction.

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

Sudden cardiovascular collapse with seizure immediately following epidural bolus is classic for LAST due to intravascular injection of local anesthetic.

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

20% lipid emulsion therapy (Intralipid 1.5 mL/kg bolus followed by infusion) is the definitive treatment specific to LAST with cardiovascular collapse.

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

Dantrolene 2.5 mg/kg IV is the specific antidote for malignant hyperthermia and should be administered immediately after stopping triggering agents.

(ABA) American Board of Anesthesiology Practice Test

(ABA) American Board of Anesthesiology Practice Test

ABA Emergency Response Procedures 3