CPR Post-Cardiac Arrest Care 5

Question 1

Which serum biomarker measured at 48–72 hours after cardiac arrest has the highest specificity for poor neurological outcome?

Accepted Answer

Neuron-specific enolase (NSE) >60 µg/L

Answer

NSE levels >60 µg/L at 48–72 hours post-arrest have high specificity for poor neurological prognosis and are part of the multimodal neuroprognostication bundle.

Question 2

A 58-year-old male achieves ROSC after VF arrest. He remains unresponsive. TTM is initiated at 33°C. At hour 6, his HR drops to 38 bpm with a MAP of 70 mmHg. What is the best action?

Accepted Answer

Continue TTM; bradycardia is an expected and acceptable response to cooling

Answer

Hypothermia-induced bradycardia is an expected physiological response to cooling; it is generally well tolerated if MAP and perfusion are adequate.

Question 3

What is the purpose of performing a CT brain scan in a comatose post-arrest patient?

Accepted Answer

Identify reversible causes such as hemorrhage and assess for cerebral edema

Answer

CT brain imaging identifies treatable causes like intracranial hemorrhage or edema, though early scans may underestimate anoxic injury.

Question 4

In post-cardiac arrest care, what is the significance of the 'post-cardiac arrest syndrome' (PCAS)?

Accepted Answer

It describes a unique pathophysiology combining brain injury, myocardial dysfunction, systemic ischemia-reperfusion, and the precipitating cause

Answer

PCAS encompasses the complex interplay of anoxic brain injury, myocardial stunning, systemic ischemia-reperfusion injury, and the underlying disease that caused the arrest.

Question 5

A post-arrest patient's PETCO2 is 38 mmHg and SpO2 is 98% on FiO2 0.40. The intensivist orders a PaO2 check which returns 210 mmHg. What adjustment should the paramedic anticipate?

Accepted Answer

FiO2 should be decreased to target PaO2 of 80–100 mmHg

Answer

A PaO2 of 210 mmHg represents hyperoxia, which increases reactive oxygen species and worsens reperfusion injury; FiO2 should be reduced.

(CPR) Certified Paramedic Response Practice Test

(CPR) Certified Paramedic Response Practice Test

CPR Post-Cardiac Arrest Care 5