Special Resuscitation Circumstances Flashcards
7 cards from real CPR practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Special Resuscitation Circumstances flashcards as text
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?
Answer: Alteplase 50mg IV bolus
Alteplase 50mg IV bolus is the recommended thrombolytic dose for cardiac arrest suspected to be caused by massive pulmonary embolism.
During resuscitation of a lightning strike victim, which phenomenon explains why the cardiac arrest may be easier to reverse than other etiologies?
Answer: Lightning causes a massive DC countershock that may spontaneously terminate within seconds, leaving a viable myocardium
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.
In a morbidly obese patient in cardiac arrest, how should hand placement and compression depth be modified?
Answer: Standard hand placement but increase compression depth to at least 2.4 inches due to increased chest wall compliance
Standard xiphoid-avoidance hand placement is maintained, but providers may need to increase force to achieve adequate compression depth through a thicker chest wall.
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?
Answer: Sodium bicarbonate 1-2 mEq/kg IV to achieve serum pH of 7.45-7.55
Sodium bicarbonate reverses TCA-induced sodium channel blockade by increasing serum pH and providing a sodium load, narrowing the QRS and improving cardiac output.
What is the primary cause of cardiac arrest in anaphylaxis, and how does it alter ACLS management?
Answer: Distributive shock and airway obstruction; epinephrine 1mg IV every 3-5 min plus aggressive fluid resuscitation
Anaphylactic arrest is driven by vasodilation and airway compromise, so IV epinephrine and high-volume fluid resuscitation are critical additions to standard ACLS.
A patient arrested after beta-blocker overdose fails to respond to standard ACLS and epinephrine. What high-dose rescue therapy should be considered?
Answer: High-dose insulin euglycemic therapy (HIET) with insulin 1 unit/kg IV bolus
High-dose insulin euglycemic therapy (HIET) improves myocardial carbohydrate metabolism and is a primary antidote for refractory beta-blocker and calcium channel blocker toxicity.
During resuscitation of a trauma patient in cardiac arrest, which intervention is the highest priority before standard ACLS?
Answer: Identify and treat reversible causes (4 H's and 4 T's) including hemorrhage, tension pneumothorax, and tamponade
Traumatic cardiac arrest is almost always caused by reversible factors; identifying and treating hemorrhage, tension pneumothorax, or tamponade is the primary intervention.