ECC Advanced Life Support & Resuscitation Techniques 3 — Questions and Answers
Question 1: A patient presents with a wide-complex tachycardia at 180 bpm. The patient is stable. The rhythm is regular. What is the first-line pharmacologic treatment if the rhythm is presumed SVT with aberrancy?
- Amiodarone 150 mg IV over 10 minutes
- Adenosine 6 mg rapid IV push (Correct answer)
- Lidocaine 1–1.5 mg/kg IV
- Magnesium sulfate 2 g IV
Correct answer: Adenosine 6 mg rapid IV push
Adenosine is the drug of choice for stable regular wide-complex tachycardia suspected to be SVT with aberrancy because it is safe and diagnostic.
Question 2: During post-cardiac arrest care, what is the recommended target range for arterial oxygen saturation (SpO2)?
- 88–92%
- 94–99% (Correct answer)
- 100%
- Greater than 85%
Correct answer: 94–99%
Post-ROSC oxygen should be titrated to an SpO2 of 94–99% to avoid both hypoxia and hyperoxia, which can worsen neurological outcomes.
Question 3: A patient in PEA arrest has a HR of 60 on the monitor. The team suspects cardiac tamponade. Which H or T is this classified under?
- Hypovolemia
- Tension pneumothorax
- Tamponade (cardiac) (Correct answer)
- Thrombosis (pulmonary)
Correct answer: Tamponade (cardiac)
Cardiac tamponade is one of the Ts in the H's and T's of reversible causes of PEA, requiring emergency pericardiocentesis.
Question 4: When performing bag-mask ventilation during CPR with an advanced airway in place, what is the recommended ventilation rate for adults?
- 1 breath every 3 seconds (20/min)
- 1 breath every 6 seconds (10/min) (Correct answer)
- 1 breath every 2 seconds (30/min)
- 1 breath every 10 seconds (6/min)
Correct answer: 1 breath every 6 seconds (10/min)
Once an advanced airway is placed, deliver 1 breath every 6 seconds (10 breaths/min) asynchronously with continuous chest compressions.
Question 5: A patient develops polymorphic VT with a prolonged QTc interval. Which drug is the treatment of choice?
- Amiodarone 300 mg IV bolus
- Magnesium sulfate 1–2 g IV (Correct answer)
- Lidocaine 1.5 mg/kg IV
- Adenosine 12 mg IV
Correct answer: Magnesium sulfate 1–2 g IV
Torsades de pointes (polymorphic VT with prolonged QTc) is treated with magnesium sulfate 1–2 g IV to stabilize the myocardium.
Question 6: Which of the following best describes the role of lidocaine in current ACLS cardiac arrest algorithms?
- First-line antiarrhythmic for VF/pVT
- Alternative antiarrhythmic when amiodarone is unavailable (Correct answer)
- Used only for PEA arrest
- Contraindicated in all cardiac arrest scenarios
Correct answer: Alternative antiarrhythmic when amiodarone is unavailable
Lidocaine is an acceptable alternative to amiodarone for shock-refractory VF/pVT when amiodarone is not available.
Question 7: A patient has ROSC after 15 minutes of CPR. She remains comatose with no purposeful movement to pain. Which post-resuscitation intervention has the strongest evidence for improving neurological outcomes?
- Immediate coronary angiography in all patients
- Targeted temperature management (TTM) between 32–36°C (Correct answer)
- Administration of sodium bicarbonate 1 mEq/kg IV
- Immediate neurology consultation only
Correct answer: Targeted temperature management (TTM) between 32–36°C
Targeted temperature management (TTM) at 32–36°C for at least 24 hours is recommended for comatose survivors of cardiac arrest to improve neurological outcomes.
ECC Advanced Life Support & Resuscitation Techniques 3
A patient presents with a wide-complex tachycardia at 180 bpm.
The patient is stable.
The rhythm is regular.
What is the first-line pharmacologic treatment if the rhythm is presumed SVT with aberrancy?