CMT CMT Emergency Response and ACLS Protocols 1 — Questions and Answers
Question 1: When a cardiac monitor technician identifies ventricular fibrillation on a remote telemetry unit, the FIRST action is to:
- Immediately defibrillate the patient
- Call the patient directly to verify consciousness
- Notify the bedside nurse or charge nurse immediately (Correct answer)
- Start CPR through the intercom
Correct answer: Notify the bedside nurse or charge nurse immediately
The CMT's first action is immediate notification of the bedside nurse since the technician cannot physically assess or treat the patient.
Question 2: Per ACLS guidelines, what is the recommended energy for the first defibrillation shock for ventricular fibrillation with a biphasic defibrillator?
- 100–120 joules
- 120–200 joules (manufacturer recommended) (Correct answer)
- 300 joules
- 360 joules
Correct answer: 120–200 joules (manufacturer recommended)
ACLS recommends 120–200 joules (biphasic, per manufacturer) for the first shock in VF, as biphasic waveforms are more effective at lower energies.
Question 3: During CPR, how frequently should the cardiac rhythm be checked?
- Every 1 minute
- Every 2 minutes (after each 5 cycles of CPR) (Correct answer)
- Every 5 minutes
- Only when a shockable rhythm is suspected
Correct answer: Every 2 minutes (after each 5 cycles of CPR)
ACLS protocol calls for rhythm checks every 2 minutes (after 5 cycles of 30:2 CPR) to minimize interruptions in chest compressions.
Question 4: A telemetry patient goes into asystole. What rhythm does the CMT confirm before reporting to the team?
- Check two leads to confirm true asystole, not fine VF or lead disconnect (Correct answer)
- Report immediately from one lead only
- Wait 30 seconds to see if rhythm returns
- Check only limb leads
Correct answer: Check two leads to confirm true asystole, not fine VF or lead disconnect
Asystole must be confirmed in at least two leads to differentiate true asystole from fine VF or artifact from lead disconnection.
Question 5: What is the recommended compression depth for adult CPR per current AHA guidelines?
- 1–1.5 inches
- At least 2 inches (5 cm), not exceeding 2.4 inches (Correct answer)
- 3 inches
- As deep as possible without restriction
Correct answer: At least 2 inches (5 cm), not exceeding 2.4 inches
AHA guidelines specify adult chest compressions should be at least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm) to optimize perfusion.
Question 6: Pulseless electrical activity (PEA) is characterized by:
- No electrical activity and no pulse
- Organized electrical activity on ECG but no palpable pulse (Correct answer)
- Chaotic electrical activity with a weak pulse
- Absence of P waves only
Correct answer: Organized electrical activity on ECG but no palpable pulse
PEA presents with organized cardiac electrical activity visible on the monitor but no palpable pulse, requiring CPR and treatment of reversible causes.
CMT CMT Emergency Response and ACLS Protocols 1
When a cardiac monitor technician identifies ventricular fibrillation on a remote telemetry unit, the FIRST action is to: