BLS Post-Resuscitation Care 3 — Questions and Answers
Question 1: A post-arrest patient develops a mean arterial pressure (MAP) of 55 mmHg. What is the recommended MAP target?
- Above 65 mmHg (Correct answer)
- Exactly 50 mmHg
- Below 60 mmHg
- Above 100 mmHg
Correct answer: Above 65 mmHg
A MAP ≥65 mmHg is the minimum recommended target to ensure adequate organ perfusion after cardiac arrest.
Question 2: When is neuroprognostication typically considered reliable after cardiac arrest?
- Within 6 hours of ROSC
- At least 72 hours after ROSC (or after rewarming) (Correct answer)
- Immediately after ROSC
- Only at 7 days post-arrest
Correct answer: At least 72 hours after ROSC (or after rewarming)
Neuroprognostication should not occur before 72 hours post-ROSC (or after rewarming) because sedatives and hypothermia can confound findings.
Question 3: Which of the following is a POOR prognostic indicator for neurological recovery post-cardiac arrest?
- Pupillary light reflexes present at 72 hours
- Bilaterally absent N20 SSEP waves (Correct answer)
- EEG showing continuous activity
- Glasgow Coma Scale improving over time
Correct answer: Bilaterally absent N20 SSEP waves
Bilaterally absent N20 somatosensory evoked potential waves at ≥72 hours strongly predict poor neurological outcome.
Question 4: Post-cardiac arrest syndrome (PCAS) includes which combination of conditions?
- Brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathology (Correct answer)
- Only neurological injury and cardiac stunning
- Fever, infection, and multi-organ failure
- Pulmonary edema, stroke, and liver failure
Correct answer: Brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathology
PCAS encompasses brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and the underlying cause of arrest.
Question 5: Which vasopressor is most commonly used to treat post-resuscitation hypotension?
- Atropine
- Norepinephrine (Correct answer)
- Sodium bicarbonate
- Adenosine
Correct answer: Norepinephrine
Norepinephrine is the preferred vasopressor for maintaining MAP ≥65 mmHg in post-cardiac arrest shock.
Question 6: A patient resuscitated from cardiac arrest develops seizures. What is the recommended management?
- Observe and reassess in 1 hour
- Treat seizures with antiepileptic medications (Correct answer)
- Perform immediate CPR again
- Administer epinephrine
Correct answer: Treat seizures with antiepileptic medications
Post-arrest seizures increase cerebral metabolic demand and worsen outcomes; they should be treated promptly with antiepileptic drugs.
Question 7: What does 'post-cardiac arrest myocardial dysfunction' typically involve?
- Permanent scarring of the myocardium
- Transient global ventricular dysfunction that usually recovers within 48–72 hours (Correct answer)
- Immediate valve rupture requiring surgery
- Irreversible cardiogenic shock
Correct answer: Transient global ventricular dysfunction that usually recovers within 48–72 hours
Post-arrest myocardial stunning is transient and typically improves within 2–3 days with appropriate hemodynamic support.
BLS Post-Resuscitation Care 3
A post-arrest patient develops a mean arterial pressure (MAP) of 55 mmHg.
What is the recommended MAP target?