ACLS - Advanced Cardiovascular Life Support BLS and High-Quality CPR Questions and Answers — Questions and Answers
Question 1: During a resuscitation attempt, the team leader observes the compressor is delivering chest compressions at a rate of 90 per minute. Which of the following is the most appropriate action?
- Continue current practice as the rate is adequate.
- Instruct the compressor to increase the rate to 100-120 per minute. (Correct answer)
- Immediately switch compressors without providing feedback.
- Recommend a compression depth of 1.5 inches.
Correct answer: Instruct the compressor to increase the rate to 100-120 per minute.
The American Heart Association guidelines for high-quality CPR state that the chest compression rate should be between 100 and 120 per minute. A rate of 90 is too slow and will not provide adequate circulation. The team leader should provide immediate, constructive feedback to correct the rate.
Question 2: A 55-year-old male collapses and is unresponsive. You are the first responder on the scene. After ensuring the scene is safe and checking for responsiveness and breathing, you activate the emergency response system. What is the next critical step in the BLS sequence?
- Open the airway and provide two rescue breaths.
- Immediately attach an AED and wait for analysis.
- Perform a detailed head-to-toe examination.
- Begin high-quality chest compressions. (Correct answer)
Correct answer: Begin high-quality chest compressions.
For an unresponsive adult victim not breathing or only gasping, the immediate priority after activating the emergency response system is to start high-quality chest compressions. The sequence C-A-B (Compressions, Airway, Breathing) is emphasized to minimize delays in blood circulation.
Question 3: Which of the following is a key component of high-quality CPR that directly impacts coronary perfusion pressure?
- Providing ventilations every 10 seconds.
- Achieving a chest compression fraction of at least 80%. (Correct answer)
- Checking for a pulse for at least 15 seconds.
- Using a compression depth of at least 3 inches.
Correct answer: Achieving a chest compression fraction of at least 80%.
Chest compression fraction is the proportion of time that chest compressions are being performed during a cardiac arrest. Minimizing interruptions and maximizing this fraction (to at least 80%) is crucial for maintaining adequate coronary perfusion pressure and increasing the chances of ROSC.
Question 4: During a two-rescuer CPR scenario on an adult patient with an advanced airway in place, what is the correct procedure for providing ventilations?
- Pause compressions to deliver two breaths every 30 compressions.
- Deliver one breath every 6 seconds without pausing compressions. (Correct answer)
- Provide two breaths every 15 compressions.
- Synchronize one breath with every fifth chest compression.
Correct answer: Deliver one breath every 6 seconds without pausing compressions.
Once an advanced airway (like an endotracheal tube or supraglottic airway) is in place, compressions and ventilations are performed asynchronously. The correct ventilation rate is one breath every 6 seconds (10 breaths per minute) while continuous chest compressions are performed.
Question 5: You are part of a resuscitation team. To ensure high-quality CPR is being delivered, which metric is most accurately monitored using quantitative waveform capnography?
- Chest compression depth.
- Arterial blood pressure.
- Effectiveness of chest compressions and potential ROSC. (Correct answer)
- Correct hand placement on the sternum.
Correct answer: Effectiveness of chest compressions and potential ROSC.
Quantitative waveform capnography measures end-tidal carbon dioxide (ETCO2). During CPR, ETCO2 values can indicate the quality of chest compressions (a value <10 mmHg suggests compressions may be inadequate). A sudden, sustained increase in ETCO2 is a strong indicator of Return of Spontaneous Circulation (ROSC).
Question 6: To minimize interruptions in chest compressions during an ACLS response, when is the ideal time to pre-charge the defibrillator?
- Immediately after the rhythm check reveals a non-shockable rhythm.
- While the compressor is completing their final cycle before a planned rhythm analysis. (Correct answer)
- After the shock has been delivered to the patient.
- As soon as the patient is first determined to be in cardiac arrest.
Correct answer: While the compressor is completing their final cycle before a planned rhythm analysis.
To ensure the shortest possible pause between stopping compressions and delivering a shock, the defibrillator should be charged before the upcoming pulse and rhythm check. This allows for immediate defibrillation if a shockable rhythm is identified, thus reducing the 'hands-off' time and improving CPR quality.
ACLS - Advanced Cardiovascular Life Support BLS and High-Quality CPR Questions and Answers
During a resuscitation attempt, the team leader observes the compressor is delivering chest compressions at a rate of 90 per minute.
Which of the following is the most appropriate action?