CPR Special Resuscitation Circumstances 3

Question 1

A patient in cardiac arrest is found with a suspected pulmonary embolism as the cause. What is the recommended thrombolytic agent and dose for arrest-level PE?

Accepted Answer

Alteplase 50mg IV bolus

Answer

Alteplase 50mg IV bolus is the recommended thrombolytic dose for cardiac arrest suspected to be caused by massive pulmonary embolism.

Question 2

During resuscitation of a lightning strike victim, which phenomenon explains why the cardiac arrest may be easier to reverse than other etiologies?

Accepted Answer

Lightning causes a massive DC countershock that may spontaneously terminate within seconds, leaving a viable myocardium

Answer

Lightning delivers a massive direct current shock that often causes transient cardiac arrest with a viable myocardium, making these arrests highly salvageable with prompt CPR.

Question 3

In a morbidly obese patient in cardiac arrest, how should hand placement and compression depth be modified?

Accepted Answer

Standard hand placement but increase compression depth to at least 2.4 inches due to increased chest wall compliance

Answer

Standard xiphoid-avoidance hand placement is maintained, but providers may need to increase force to achieve adequate compression depth through a thicker chest wall.

Question 4

A patient is in cardiac arrest after ingesting a massive dose of a tricyclic antidepressant (TCA). In addition to standard ACLS, which treatment is most critical?

Accepted Answer

Sodium bicarbonate 1-2 mEq/kg IV to achieve serum pH of 7.45-7.55

Answer

Sodium bicarbonate reverses TCA-induced sodium channel blockade by increasing serum pH and providing a sodium load, narrowing the QRS and improving cardiac output.

Question 5

What is the primary cause of cardiac arrest in anaphylaxis, and how does it alter ACLS management?

Accepted Answer

Distributive shock and airway obstruction; epinephrine 1mg IV every 3-5 min plus aggressive fluid resuscitation

Answer

Anaphylactic arrest is driven by vasodilation and airway compromise, so IV epinephrine and high-volume fluid resuscitation are critical additions to standard ACLS.

(CPR) Certified Paramedic Response Practice Test

(CPR) Certified Paramedic Response Practice Test

CPR Special Resuscitation Circumstances 3