Megacode Scenario 2
Instructions: Evaluate the case and use your knowledge of ACLS algorithms to answer each question. You will receive a score at the end of the test. You may repeat this simulation as often as you like, until you are confident in your ability to intervene effectively in similar situations. There are 21 questions in this simulation.
1. You are walking along the street when an elderly gentleman ahead of you suddenly collapses. You rush to him and find him unresponsive. What would be your next step?
2. You have called for help and determined that the patient does not have a pulse. EMS arrives while you are performing one-person CPR. They bring you a defibrillator. You start to attach the biphasic defibrillator’s pads to the patient’s chest, while one EMS member performs CPR and an intravenous line is secured by a second EMS team member. Identify the rhythm on the defibrillator:
3. What would be your immediate next intervention?
4. What is your next step immediately after defibrillation?
5. You resume CPR. After 5 cycles of CPR (approximately 2 minutes), what should you do?
6. You recheck the rhythm on the monitor after five cycles of CPR. What should you do now?
7. You administer the epinephrine and resume CPR, as the patient is still pulseless and apneic. After five cycles of CPR you analyze the rhythm. Identify the rhythm.
8. You continue the standard management and after a repeated shock you see no change on the monitor. You consider administering an antiarrhythmic. What is your first choice in antiarrhythmics?
9. What would be the first dose of Amiodarone you would administer?
10. What would be the second dose if you decide to repeat the drug?
11. You ask the paramedic who came with EMS to prepare Amiodarone 300 mg stat, but you are told that the emergency drug kit does not contain Amiodarone, as it was just used on the call previous to this one and they have not had time to restock. Which drug could be used as an alternative to Amiodarone in this case?
12. Which drug can be given every 3-5 minutes during CPR?
13. Which alternative drug could be administered in place of the first or second dose of epinephrine?
14. What should be done immediately after any intravenous drug in administered?
15. You resume high quality CPR. Which of the following represents high quality CPR?
16. Which of the following may be used in the treatment of polymorphic ventricular tachycardia?
17. After a cycle of CPR, you pause to check the patient’s rhythm and pulse. You are informed that the patient now has a faint, albeit slow and irregular, pulse. The monitor shows the following rhythm. Can you diagnose the rhythm?
18. You administer atropine, which does did not prove to be of any help. As you are setting up for transcutaneous pacing, the monitor suddenly shows the following rhythm. Can you diagnose the rhythm?
19. You immediately resume CPR. What would be your next step in management?
20. The patient achieves ROSC (return of spontaneous circulation). Which of the following is recommended in the immediate post-cardiac arrest period?
21. The patient is unable to follow verbal commands. You should consider:
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