Electrical Therapies and Defibrillation Flashcards
7 cards from real ACLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Electrical Therapies and Defibrillation flashcards as text
Which of the following is the most appropriate initial action before performing elective synchronized cardioversion of a stable but symptomatic patient?
Answer: Ensure IV access and provide procedural sedation/analgesia
Elective cardioversion is painful; IV access must be secured and procedural sedation/analgesia administered to ensure patient comfort and cooperation.
What is the preferred pad placement when standard anterolateral positioning is not effective or feasible during defibrillation?
Answer: Anterior-posterior placement (one pad on front chest, one on back)
Anterior-posterior pad placement (right anterior chest and left posterior subscapular area) is an effective alternative that may improve defibrillation success for some patients.
If a patient with an implanted defibrillator (ICD) is in VF and the ICD has failed to convert the rhythm, what should the rescuer do?
Answer: Deliver external defibrillation, placing pads at least 1 inch from the device
If an ICD fails to terminate VF, external defibrillation should be performed with pads placed away from the device, as waiting is not acceptable during cardiac arrest.
What is the recommended current output starting point when initiating transcutaneous pacing, and how should it be adjusted?
Answer: Start at the lowest output and increase until electrical and mechanical capture is achieved
Pacing current should start low and be gradually increased until consistent electrical capture (wide QRS after spike) and mechanical capture (palpable pulse) are confirmed.
During a cardiac arrest resuscitation, when should defibrillation be performed in relation to epinephrine administration?
Answer: Defibrillation takes priority and should not be delayed for drug administration
Defibrillation is the definitive treatment for VF/pVT and should not be delayed; early defibrillation is the single most important intervention to improve survival.
When synchronized cardioversion is urgently needed in an unstable patient but the synchronization feature fails to work, what is the correct next step?
Answer: Proceed with unsynchronized high-energy defibrillation if the patient is extremely unstable
In an extremely unstable patient where synchronization fails and delay is life-threatening, unsynchronized defibrillation should be performed rather than withholding the shock.
What is the approximate hands-off time target that providers should aim for when performing defibrillation during CPR?
Answer: Less than 5 seconds from last compression to shock delivery
ACLS guidelines emphasize minimizing hands-off time; the peri-shock pause should be less than 5 seconds to maximize myocardial perfusion pressure before defibrillation.