This case will test your knowledge of several different ACLS pathways. Be aware of when the algorithm is changing. Pay attention to both the patient and the rhythm. There will be 19 questions at the end of this test. You should repeat this test periodically to reinforce your ability and confidence to handle situations such as this one.
Your patient arrives in the Emergency Department complaining of chest pressure and weakness. She is a 78-year-old woman with a PMH of Type II Diabetes Mellitus and hypertension. On examination, you find:
1. Identify the rhythm.
2. What is your next intervention?
3. Which of the following are possible modalities of treatment available?
4. What signs or symptoms might lead the physician to suggest TCP?
5. Your first intervention is:
6. The mode of action of epinephrine includes:
7. In the 2010 Guidelines, what medication was recommended as an alternative to TCP in the patient with unstable or symptomatic bradycardia?
8. The patient develops the rhythm shown below. Can you identify that rhythm?
9. As you attempt to pace the patient, her condition worsens and the monitor shows the following rhythm:
You identify the rhythm as:
10. What ACLS algorithm is appropriate in this situation?
11. You decide to act. What is your next intervention?
12. What do you do next?
13. How many cycles of CPR should you perform?
14. In ventricular fibrillation, after delivering one shock and five cycles of CPR, you should:
15. The patient's condition does not change after one shock and 5 cycles of CPR.
16. You have repeated a shock and followed it with 5 cycles of CPR. The rhythm is unchanged.
17. The patient's rhythm does not change, so you give epinephrine while continuing CPR.
What is the correct dosage?
18. What is the antiarrhythmic agent you might consider next if there is no response?
19. The patient has ROSC with a normal sinus rhythm. What is your next action?
Thanks for taking our Megacode Scenario 6.