CPR Emergency Medical Procedures & Protocols 2 — Questions and Answers
Question 1: When performing needle decompression for tension pneumothorax, which landmark is used on the affected side?
- 2nd intercostal space, midclavicular line (Correct answer)
- 5th intercostal space, midaxillary line
- 4th intercostal space, midclavicular line
- 3rd intercostal space, anterior axillary line
Correct answer: 2nd intercostal space, midclavicular line
The 2nd intercostal space at the midclavicular line is the primary landmark for needle thoracostomy to relieve tension pneumothorax.
Question 2: A patient presents with a GCS of 8 and is unresponsive to verbal stimuli. What is the MOST appropriate initial airway intervention?
- Nasopharyngeal airway insertion
- Oropharyngeal airway with BVM ventilation
- Endotracheal intubation (Correct answer)
- High-flow oxygen via non-rebreather mask
Correct answer: Endotracheal intubation
A GCS of 8 or below indicates the need for definitive airway management, and endotracheal intubation is the gold standard.
Question 3: Which drug is the FIRST-LINE treatment for symptomatic bradycardia with hemodynamic instability in adults?
- Epinephrine 1 mg IV
- Atropine 0.5 mg IV (Correct answer)
- Dopamine infusion at 5 mcg/kg/min
- Adenosine 6 mg rapid IV push
Correct answer: Atropine 0.5 mg IV
Atropine 0.5 mg IV is the first-line pharmacological agent for symptomatic bradycardia per AHA ACLS guidelines.
Question 4: During rapid sequence intubation (RSI), succinylcholine is contraindicated in which of the following patients?
- A 40-year-old with active asthma exacerbation
- A 25-year-old with severe head injury
- A 60-year-old with crush injury 72 hours prior (Correct answer)
- A 30-year-old in anaphylactic shock
Correct answer: A 60-year-old with crush injury 72 hours prior
Succinylcholine is contraindicated in crush injuries older than 24-48 hours due to upregulation of acetylcholine receptors causing life-threatening hyperkalemia.
Question 5: A patient is found in cardiac arrest with a narrow complex PEA rhythm. Which reversible cause should be treated FIRST in the field?
- Pulmonary embolism
- Hypothermia
- Tension pneumothorax (Correct answer)
- Hyperkalemia
Correct answer: Tension pneumothorax
Tension pneumothorax is a common, immediately treatable cause of PEA that can be rapidly reversed with needle decompression in the field.
Question 6: When using a King LT supraglottic airway, correct placement is confirmed by which primary method?
- Direct visualization of the cords
- Capnography showing ETCO2 >35 mmHg
- Bilateral breath sounds and chest rise with ventilation (Correct answer)
- Pulse oximetry improvement to >95%
Correct answer: Bilateral breath sounds and chest rise with ventilation
Primary confirmation of supraglottic airway placement relies on bilateral breath sounds and visible chest rise during ventilation.
Question 7: According to AHA guidelines, what is the recommended compression-to-ventilation ratio for single-rescuer adult CPR?
- 15:2
- 30:2 (Correct answer)
- 20:2
- 30:1
Correct answer: 30:2
The AHA recommends a 30:2 compression-to-ventilation ratio for single-rescuer adult CPR to maximize perfusion pressure.
CPR Emergency Medical Procedures & Protocols 2
When performing needle decompression for tension pneumothorax, which landmark is used on the affected side?