ECC Defibrillation & Airway Management 2 — Questions and Answers
Question 1: During an AED analysis, a bystander accidentally touches the patient. What is the most likely consequence?
- No effect on shock delivery
- The AED will abort analysis and require restart
- The bystander may receive part of the shock energy (Correct answer)
- The AED will automatically compensate and proceed
Correct answer: The bystander may receive part of the shock energy
Contact with the patient during AED analysis or shock delivery can result in the bystander receiving a portion of the electrical discharge.
Question 2: When using a bag-mask device for a patient with suspected cervical spine injury, which airway maneuver is preferred?
- Head-tilt chin-lift
- Jaw thrust without head tilt (Correct answer)
- Neck hyperextension
- Blind nasotracheal insertion
Correct answer: Jaw thrust without head tilt
The jaw thrust maneuver opens the airway without moving the cervical spine, making it the preferred technique in suspected spinal injury.
Question 3: What is the recommended energy dose for the SECOND defibrillation attempt with a biphasic AED when the first shock was delivered at 200 J?
- 100 J
- 200 J or higher per manufacturer (Correct answer)
- 360 J
- 150 J
Correct answer: 200 J or higher per manufacturer
For subsequent biphasic shocks, the same or higher energy level (per manufacturer specification) is recommended, typically ≥200 J.
Question 4: Which finding on end-tidal CO2 (ETCO2) monitoring during CPR suggests the patient may have achieved ROSC?
- ETCO2 drops below 10 mmHg
- ETCO2 suddenly rises above 40 mmHg (Correct answer)
- ETCO2 remains flat at 20 mmHg
- ETCO2 decreases from 25 to 15 mmHg
Correct answer: ETCO2 suddenly rises above 40 mmHg
A sudden sustained rise in ETCO2 to ≥40 mmHg during CPR is a strong indicator of return of spontaneous circulation.
Question 5: For an unresponsive adult in VF, how long should a single defibrillation attempt (shock + CPR) cycle last before re-analyzing rhythm?
- 1 minute of CPR then re-analyze
- 2 minutes of CPR then re-analyze (Correct answer)
- 30 seconds of CPR then re-analyze
- 3 minutes of CPR then re-analyze
Correct answer: 2 minutes of CPR then re-analyze
After each defibrillation attempt, 2 minutes (approximately 5 cycles) of high-quality CPR should be performed before rhythm re-analysis.
Question 6: Which airway adjunct is most appropriate for a semiconscious patient with an intact gag reflex?
- Oropharyngeal airway (OPA)
- Nasopharyngeal airway (NPA) (Correct answer)
- Supraglottic airway device
- Endotracheal tube
Correct answer: Nasopharyngeal airway (NPA)
The nasopharyngeal airway is tolerated in patients with a gag reflex, unlike the oropharyngeal airway which can induce vomiting in conscious patients.
Question 7: AED pads should NOT be placed in which configuration?
- Right sternal border, below clavicle / left lateral chest
- Anterior-posterior (front and back)
- Both pads on the left lateral chest wall (Correct answer)
- Apex-sternum positioning
Correct answer: Both pads on the left lateral chest wall
Placing both pads on the same side of the chest does not allow adequate current to pass through the heart, rendering defibrillation ineffective.
ECC Defibrillation & Airway Management 2
During an AED analysis, a bystander accidentally touches the patient.
What is the most likely consequence?