CCS Emergency Procedures & Response 2 — Questions and Answers
Question 1: A patient in the cardiac catheterization lab develops ventricular fibrillation. What is the FIRST action?
- Administer amiodarone IV
- Deliver unsynchronized defibrillation at 200J biphasic (Correct answer)
- Begin chest compressions
- Call a code and wait for the team
Correct answer: Deliver unsynchronized defibrillation at 200J biphasic
Ventricular fibrillation is treated immediately with unsynchronized defibrillation; CPR is initiated only if a defibrillator is not immediately available.
Question 2: Which vasopressor is the first-line agent recommended in cardiac arrest according to the 2020 AHA guidelines?
- Vasopressin
- Norepinephrine
- Epinephrine (Correct answer)
- Dopamine
Correct answer: Epinephrine
Epinephrine 1 mg IV/IO every 3–5 minutes remains the first-line vasopressor in cardiac arrest per AHA guidelines.
Question 3: A patient presents with ST-elevation in leads II, III, and aVF with reciprocal changes in I and aVL. Which coronary artery is most likely occluded?
- Left anterior descending
- Left circumflex
- Right coronary artery (Correct answer)
- Left main coronary artery
Correct answer: Right coronary artery
Inferior STEMI (II, III, aVF) with reciprocal lateral changes classically indicates right coronary artery occlusion.
Question 4: During CPR, what is the recommended compression-to-ventilation ratio for a single rescuer managing an adult cardiac arrest?
- 15:2
- 30:2 (Correct answer)
- 5:1
- 30:1
Correct answer: 30:2
A 30:2 compression-to-ventilation ratio is recommended for single-rescuer adult CPR to minimize interruptions in chest compressions.
Question 5: A patient develops pulseless electrical activity (PEA). Which of the following is a reversible cause represented by the 'H's'?
- Hypothermia (Correct answer)
- Heart failure
- Hemoptysis
- Hypertension
Correct answer: Hypothermia
Hypothermia is one of the 'H' reversible causes of PEA (H's and T's); it must be identified and treated to restore organized cardiac output.
Question 6: What is the maximum dose of adenosine for terminating supraventricular tachycardia if the initial 6 mg dose fails?
- 9 mg
- 12 mg (Correct answer)
- 18 mg
- 24 mg
Correct answer: 12 mg
If the initial 6 mg adenosine dose fails, a second dose of 12 mg IV push may be administered, with a possible third dose of 12 mg.
Question 7: A post-cardiac-arrest patient achieves ROSC. Target temperature management (TTM) should maintain core temperature at:
- 32–34°C for 48 hours
- 36–37°C for 24 hours
- 34–36°C for 24 hours or longer (Correct answer)
- 32°C for 12 hours only
Correct answer: 34–36°C for 24 hours or longer
Current guidelines support targeted temperature management at 32–36°C for at least 24 hours after ROSC to improve neurological outcomes.
CCS Emergency Procedures & Response 2
A patient in the cardiac catheterization lab develops ventricular fibrillation.
What is the FIRST action?