ECC Advanced Life Support & Resuscitation Techniques 2 — Questions and Answers
Question 1: During ACLS, a patient in pulseless ventricular tachycardia receives one shock. The rhythm immediately converts to sinus bradycardia at 38 bpm with a pulse. What is the next priority action?
- Resume CPR for 2 minutes
- Administer atropine 0.5 mg IV (Correct answer)
- Administer amiodarone 300 mg IV
- Begin transcutaneous pacing
Correct answer: Administer atropine 0.5 mg IV
Symptomatic bradycardia post-resuscitation is treated first with atropine 0.5 mg IV, repeated every 3–5 minutes up to 3 mg total.
Question 2: A resuscitation team is performing CPR on an adult. The team member doing compressions is fatiguing. According to AHA guidelines, how often should compressor roles be rotated?
- Every 5 minutes
- Every 2 minutes (each rhythm check) (Correct answer)
- Every 10 minutes
- Only when the compressor requests relief
Correct answer: Every 2 minutes (each rhythm check)
Compressor roles should be switched every 2 minutes (at each rhythm check) to prevent fatigue and maintain high-quality compressions.
Question 3: A patient in cardiac arrest has a waveform capnography reading that suddenly rises to 40 mmHg during CPR. What does this most likely indicate?
- Esophageal intubation
- Return of spontaneous circulation (ROSC) (Correct answer)
- Hyperventilation by the rescuer
- Worsening metabolic acidosis
Correct answer: Return of spontaneous circulation (ROSC)
A sudden rise in ETCO2 to near-normal levels (≥40 mmHg) during CPR is a reliable indicator of ROSC.
Question 4: Which of the following is the recommended vasopressor dose of epinephrine for cardiac arrest in adults?
- 0.5 mg IV every 3–5 minutes
- 1 mg IV every 3–5 minutes (Correct answer)
- 2 mg IV every 10 minutes
- 0.1 mg IV every 2 minutes
Correct answer: 1 mg IV every 3–5 minutes
The standard dose of epinephrine in adult cardiac arrest is 1 mg IV/IO every 3–5 minutes.
Question 5: A patient with witnessed VF receives a shock, CPR resumes, and after 2 minutes the rhythm is checked and shows organized activity. Which action is correct?
- Deliver a second immediate shock
- Check for a pulse (Correct answer)
- Administer amiodarone 150 mg IV
- Increase compression rate to 120/min
Correct answer: Check for a pulse
Any organized rhythm after a shock should prompt an immediate pulse check to determine if ROSC has occurred.
Question 6: During asystole management, which intervention should be performed after confirming the rhythm in two leads?
- Immediate defibrillation at 360 J
- Epinephrine 1 mg IV and high-quality CPR (Correct answer)
- Atropine 3 mg IV bolus
- Cardioversion at 200 J synchronized
Correct answer: Epinephrine 1 mg IV and high-quality CPR
Asystole is non-shockable; the correct approach is epinephrine 1 mg IV/IO every 3–5 minutes combined with high-quality CPR.
Question 7: What is the recommended target fraction of chest compression time (CCF) during resuscitation according to current AHA guidelines?
- Greater than 50%
- Greater than 60%
- Greater than 80% (Correct answer)
- Greater than 95%
Correct answer: Greater than 80%
Current AHA guidelines recommend a chest compression fraction (CCF) greater than 80% to maximize perfusion during resuscitation.
ECC Advanced Life Support & Resuscitation Techniques 2
During ACLS, a patient in pulseless ventricular tachycardia receives one shock.
The rhythm immediately converts to sinus bradycardia at 38 bpm with a pulse.
What is the next priority action?