ACLS Electrical Therapies and Defibrillation 3

Question 1

Which of the following is the most appropriate initial action before performing elective synchronized cardioversion of a stable but symptomatic patient?

Accepted Answer

Ensure IV access and provide procedural sedation/analgesia

Answer

Elective cardioversion is painful; IV access must be secured and procedural sedation/analgesia administered to ensure patient comfort and cooperation.

Question 2

What is the preferred pad placement when standard anterolateral positioning is not effective or feasible during defibrillation?

Accepted Answer

Anterior-posterior placement (one pad on front chest, one on back)

Answer

Anterior-posterior pad placement (right anterior chest and left posterior subscapular area) is an effective alternative that may improve defibrillation success for some patients.

Question 3

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?

Accepted Answer

Deliver external defibrillation, placing pads at least 1 inch from the device

Answer

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.

Question 4

What is the recommended current output starting point when initiating transcutaneous pacing, and how should it be adjusted?

Accepted Answer

Start at the lowest output and increase until electrical and mechanical capture is achieved

Answer

Pacing current should start low and be gradually increased until consistent electrical capture (wide QRS after spike) and mechanical capture (palpable pulse) are confirmed.

Question 5

During a cardiac arrest resuscitation, when should defibrillation be performed in relation to epinephrine administration?

Accepted Answer

Defibrillation takes priority and should not be delayed for drug administration

Answer

Defibrillation is the definitive treatment for VF/pVT and should not be delayed; early defibrillation is the single most important intervention to improve survival.

ACLS Practice Test

ACLS Practice Test

ACLS Electrical Therapies and Defibrillation 3