This scenario will test your ability to work through a particular ACLS algorithm. You can refer to the algorithms on the site, but your goal should be to attain the ability to smoothly and rapidly deliver the correct interventions in any resuscitation. You can repeat the simulation as often as necessary. You will receive a score at the end of the simulation. This scenario has 21 questions.
You are making pre-rounds on the fourth floor. As you enter the room of a patient with end-stage renal disease, 1 day after dialysis, you find your patient, a 53 year old woman, unresponsive and pulseless with a bag of Cheetos on her lap.
1. After you call a code blue, what is your next move?
2. After beginning CPR, you next take which of the following actions:
3. What is the maximum dose of epinephrine that can be given in ACLS?
4. You have given epinephrine. What is your next action?
5. You consider reversible causes (H's and T's).
Which of the following is not considered part of the ACLS algorithm for PEA?
6. Which of the following ARE considered potentially reversible causes of PEA in ACLS?
7. What is the probable cause of this patient's arrest?
8. This patient does not have an advanced airway. You continue resuscitation attempts with CPR. What is the ratio of compressions:breaths in two person CPR without an advanced airway?
9. You complete 5 cycles of CPR. What is your next intervention?
10. The patient remains pulseless with the following rhythm:
The patient is being ventilated with a bag valve mask, and has no advanced airway. What is your next step in this resuscitation attempt?
11. After intubation and while giving CPR you are considering your plan of action.
12. You give 1 mg epinephrine and complete a cycle of CPR. The rhythm on the monitor now displays this:
What is your course of action?
13. The patient is still pulseless.
14. Following defibrillation, what is the appropriate action to take?
15. You complete 5 cycles of CPR. You check the rhythm, which remains the same.
The patient remains pulseless. What action should you take next?
16. You defibrillate with 200 J. Your patient remains in pulseless v-tach.
What action do you consider next?
17. You administer vasopressin 40 mg IV. You complete 5 cycles of CPR. The rhythm remains unchanged.
What drug do you consider now?
18. You administer amiodarone and complete 5 cycles of CPR. You defibrillate the patient one more time with 200 J. There is no change in the rhythm.
What do you do now?
19. You administer amiodarone once more after shocking.
What dose do you give?
20. Your patient regains a pulse, with a BP of 103/88. The monitor shows the following rhythm:
The patient is breathing spontaneously. You prepare for post-resuscitative care. What is your priority?
21. What is the dose of an amiodarone infusion given after ROSC?
Thanks for taking our Megacode Scenario 5.