BLS Post-Resuscitation Care 4 — Questions and Answers
Question 1: Which temperature range defines fever that should be actively prevented in comatose post-arrest patients?
- Above 37.5°C (Correct answer)
- Above 40°C
- Above 38.5°C
- Above 36°C
Correct answer: Above 37.5°C
Fever is defined as ≥37.5°C in post-arrest guidelines, and active prevention is recommended to protect neurological outcomes.
Question 2: Which finding on EEG is associated with poor neurological prognosis after cardiac arrest?
- Alpha pattern activity
- Burst suppression with identical bursts (Correct answer)
- Continuous normal background
- Sleep-wake cycles present
Correct answer: Burst suppression with identical bursts
Burst suppression with identical (stereotyped) bursts is a malignant EEG pattern predictive of poor neurological outcome.
Question 3: A post-arrest patient's CT scan of the head shows loss of gray-white matter differentiation. What does this indicate?
- Normal post-resuscitation finding
- Diffuse anoxic brain injury (Correct answer)
- Intracranial hemorrhage
- Cerebral venous thrombosis
Correct answer: Diffuse anoxic brain injury
Loss of gray-white matter differentiation on CT indicates diffuse cerebral edema from anoxic brain injury, a poor prognostic sign.
Question 4: What is the primary goal of targeted temperature management (TTM) when implemented after cardiac arrest?
- Reduce risk of cardiac arrhythmia
- Provide neuroprotection by reducing cerebral metabolic demand (Correct answer)
- Prevent infection
- Reverse myocardial stunning
Correct answer: Provide neuroprotection by reducing cerebral metabolic demand
TTM reduces cerebral oxygen demand and inflammatory injury, providing neuroprotection during the vulnerable post-arrest period.
Question 5: Why is hyperoxia harmful in the post-resuscitation period?
- It causes cardiac arrhythmias
- It worsens reperfusion injury through free radical production (Correct answer)
- It lowers blood pressure significantly
- It causes hypercapnia
Correct answer: It worsens reperfusion injury through free radical production
Excess oxygen after ROSC generates reactive oxygen species that exacerbate reperfusion injury in ischemic tissues, particularly the brain.
Question 6: Which laboratory value, if markedly elevated 48–72 hours post-arrest, suggests severe neurological injury?
- Troponin
- Neuron-specific enolase (NSE) (Correct answer)
- Creatinine
- C-reactive protein
Correct answer: Neuron-specific enolase (NSE)
Markedly elevated NSE at 48–72 hours after cardiac arrest correlates with severe neurological injury and poor neurological prognosis.
Question 7: A patient is resuscitated from ventricular fibrillation with no clear reversible cause identified in the field. What should be considered after stabilization?
- Immediate discharge home
- Evaluation for implantable cardioverter-defibrillator (ICD) placement (Correct answer)
- Permanent pacemaker insertion
- No further cardiac workup needed
Correct answer: Evaluation for implantable cardioverter-defibrillator (ICD) placement
Survivors of VF arrest without a clearly reversible cause are at high risk for recurrence and are candidates for ICD implantation.
BLS Post-Resuscitation Care 4
Which temperature range defines fever that should be actively prevented in comatose post-arrest patients?