DCAS Cardiac Emergency Protocols 2 — Questions and Answers
Question 1: What is pulseless ventricular tachycardia (pVT) and how should DCAS paramedics manage it?
- A slow heart rhythm treated with atropine
- A rapid ventricular rhythm without a pulse, treated with immediate defibrillation and CPR (Correct answer)
- A normal rhythm variation requiring observation
- A rhythm only found in children
Correct answer: A rapid ventricular rhythm without a pulse, treated with immediate defibrillation and CPR
Pulseless VT is a rapid, organized ventricular rhythm that does not produce effective cardiac output. It is a shockable rhythm treated with immediate defibrillation followed by CPR, similar to ventricular fibrillation.
Question 2: What is the DCAS protocol for managing acute coronary syndrome (ACS) in the pre-hospital setting?
- Only provide oxygen and transport
- Aspirin 300mg, GTN (if systolic BP >90mmHg), morphine for pain, 12-lead ECG, and rapid transport to appropriate facility (Correct answer)
- Wait for hospital treatment
- Only apply cardiac monitoring
Correct answer: Aspirin 300mg, GTN (if systolic BP >90mmHg), morphine for pain, 12-lead ECG, and rapid transport to appropriate facility
DCAS ACS protocol includes aspirin 300mg chewed, sublingual GTN (if systolic BP permits), morphine for pain management, continuous cardiac monitoring with 12-lead ECG, and rapid transport to appropriate cardiac facility.
Question 3: What is the significance of the 'chain of survival' concept in DCAS cardiac care?
- A chain used to secure patients during transport
- A sequence of critical actions: early recognition, early CPR, early defibrillation, and early advanced care that maximizes cardiac arrest survival (Correct answer)
- A hospital discharge checklist
- A paramedic training sequence
Correct answer: A sequence of critical actions: early recognition, early CPR, early defibrillation, and early advanced care that maximizes cardiac arrest survival
The chain of survival represents the sequence of time-critical interventions — early recognition and activation, early CPR, early defibrillation, and early advanced care — each link of which improves cardiac arrest outcomes.
Question 4: How should DCAS paramedics manage symptomatic bradycardia?
- No treatment is needed
- Administer atropine 500mcg IV, consider transcutaneous pacing if atropine is ineffective (Correct answer)
- Immediately defibrillate
- Only provide oxygen therapy
Correct answer: Administer atropine 500mcg IV, consider transcutaneous pacing if atropine is ineffective
DCAS protocols for symptomatic bradycardia include IV atropine 500mcg (up to 3mg total), and if ineffective, transcutaneous pacing to maintain adequate heart rate and perfusion.
Question 5: What post-resuscitation care should DCAS paramedics provide after return of spontaneous circulation (ROSC)?
- Stop all monitoring
- Maintain airway, target SpO2 94-98%, obtain 12-lead ECG, maintain systolic BP >90mmHg, and consider targeted temperature management (Correct answer)
- Simply transport to nearest hospital
- Discontinue IV access
Correct answer: Maintain airway, target SpO2 94-98%, obtain 12-lead ECG, maintain systolic BP >90mmHg, and consider targeted temperature management
Post-ROSC care includes airway management, titrating oxygen to SpO2 94-98%, 12-lead ECG to identify STEMI, maintaining adequate blood pressure, and preparing for targeted temperature management at hospital.
Question 6: What is the DCAS protocol for managing unstable tachycardia?
- Administer atropine
- Perform synchronized cardioversion after sedation if the patient is hemodynamically unstable (Correct answer)
- Give aspirin only
- Wait for natural conversion
Correct answer: Perform synchronized cardioversion after sedation if the patient is hemodynamically unstable
For hemodynamically unstable tachycardia with pulse, DCAS protocols require synchronized cardioversion with appropriate sedation, as the unstable rhythm threatens organ perfusion and requires immediate electrical treatment.
DCAS Cardiac Emergency Protocols 2
What is pulseless ventricular tachycardia (pVT) and how should DCAS paramedics manage it?