Megacode Scenario 3
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 20 questions in this simulation.
1. You are at an accident site where a young 35-year-old male is lying unresponsive with no palpable pulse. The patient has a cervical collar in place and has been placed on a cardiac monitor. Identify the rhythm.
2. How do you define pulseless electrical activity?
3. CPR is in progress. You have requested that epinephrine be administered, but the paramedics are having difficulty in securing intravenous access. What other options for the administration of epinephrine are available?
4. Two minutes have passed. High-quality CPR continues. There is good chest rise with ventilations using a bag-valve mask, and an intraosseous line has now been secured. What is your next intervention?
5. Which of the following is not one of the 5H’s in ACLS?
6. Considering the history of trauma in the present scenario, all the following could be a potential case of PEA except:
7. If an expanding tension pneumothorax is the underlying cause of PEA, which one of the following could be a life-saving intervention in the present scenario?
8. All of the following features may help to diagnose tension pneumothorax except:
9. Apart from CPR, if hypovolemia secondary to blood loss from trauma is suspected, what additional measure may be helpful?
10. Which of the following causes of PEA has the worst prognosis after corrective measures have been initiated?
11. On the monitor you suddenly note a flat line (asystole) and you want to ensure that the rhythm is, in fact, asystole. What are the potential causes of an isoelectric ECG?
12. The treatment of patients in PEA cardiac arrest revolves around the following:
13. What should be your next step in managing a patient with PEA, after starting high-quality CPR?
14. After a cycle of CPR (2 minutes), you decide to recheck the patient’s rhythm. To minimize interruptions in CPR, you should take no longer than _________ to check the rhythm.
15. Pulseless electrical activity caused by hyperkalemia is manifested by the following findings on an electrocardiogram:
16. Commonly employed medications used for managing life-threatening hyperkalemia include:
17. Apart from a controlled infusion of potassium in patients with suspected hypokalemia, replacement of which of the following electrolytes may be helpful in managing a hypokalemic patient in PEA?
18. The most common ECG manifestation following poisoning (ingestion of a toxin) before the patient goes into PEA is:
19. In a trauma patient with PEA and pericardial tamponade as the suspected possible cause, what would be the treatment of choice in a hospital?
20. All the following are ACLS recommendations for the management of a patient in PEA except:
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