CPR & Airway
What is the recommended compression rate for high-quality adult CPR?
100–120 compressions/minute.
On an ECG recorded at 25 mm/s, how can you quickly calculate the heart rate using the large-box method?
300 divided by the number of large squares between two consecutive R waves.
Name the two shockable cardiac-arrest rhythms.
Ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT)
What does the mnemonic MONA stand for in your ACS teaching?
Morphine – Oxygen – Nitroglycerin – Aspirin.
What are the two major types of stroke?
Ischemic stroke and hemorrhagic stroke
During single-rescuer adult CPR, what is the compression-to-ventilation ratio?
30 compressions : 2 breaths
Which arrhythmia is characterized by an irregularly irregular rhythm and absence of distinct P waves?
Atrial fibrillation (AF).
Which two cardiac-arrest rhythms are classified as non-shockable?
Asystole and pulseless electrical activity (PEA).
What antiplatelet drug is given orally and chewed in ACS, according to the course material?
Aspirin, 160–325 mg, chewed.
What is one of the most important pieces of information EMS should establish when assessing a suspected stroke patient?
The time the patient was last known to be normal / symptom onset time.
You are performing CPR and the first rescue breath does not produce visible chest rise. What should you do?
Reposition the mask, ensure a proper seal, reopen the airway, and attempt the second breath. If there is still no chest rise, immediately resume compressions.
An ECG shows P waves marching through at a regular rate, QRS complexes occurring independently, and no relationship between P waves and QRS complexes. What is the diagnosis?
Third-degree AV block (complete heart block)
A patient is unresponsive, has no normal breathing, and no palpable pulse. The monitor shows VF. What is the immediate electrical treatment?
Immediate defibrillation, accompanied by high-quality CPR.
Name two situations in which nitroglycerin should NOT be given.
Any two of:
A suspected stroke patient arrives at the emergency department. What brain imaging should be prepared to distinguish ischemic from hemorrhagic stroke?
Brain CT or MRI. The course emphasizes imaging to determine whether hemorrhage is present.
An unconscious patient has no gag reflex. Which airway adjunct can be used to prevent the tongue from obstructing the airway?
Oropharyngeal airway (OPA). It is used in unconscious patients without a cough or gag reflex.
A patient has a regular tachycardia with wide QRS complexes greater than 0.12 seconds and absent P waves. What rhythm should you recognize?
Ventricular tachycardia (VT).
The monitor shows organized electrical activity, but the patient has no palpable pulse. What rhythm is this, and is it shockable?
Pulseless electrical activity (PEA), and it is non-shockable. Start CPR, administer appropriate medication such as epinephrine, and search for reversible causes.
A patient has a stable regular narrow-complex tachycardia. Vagal maneuvers fail. What medication should you give next, and what is the initial dose?
Adenosine 6 mg rapid IV push. If unsuccessful, a 12 mg rapid IV push may be given.
According to the course material, within what time window can selected ischemic stroke patients receive fibrinolytic therapy?
Within 3 hours, with an extended window to 4.5 hours for selected patients.
A cardiac-arrest patient has an advanced airway successfully placed. How should you modify CPR ventilation?
Continue continuous chest compressions at 100–120/min and provide 1 breath every 6 seconds (10 breaths/min).
An ECG shows progressively lengthening PR intervals followed by a dropped QRS complex. What is the rhythm?
Second-degree AV block, Mobitz I (Wenckebach).
A patient develops an unstable tachyarrhythmia but still has a pulse. Should you defibrillate or perform synchronized cardioversion?
Synchronized cardioversion. It synchronizes the shock with the QRS complex and is the first-line electrical treatment for hemodynamically unstable tachyarrhythmias with a pulse.
A patient with VF remains in cardiac arrest. Which antiarrhythmic medications are identified in the course for VF/pulseless VT, and what are the listed doses?
Amiodarone: 300 mg IV push initially, followed by 150 mg IV push as the second dose.
Lidocaine: 1–1.5 mg/kg IV initially, followed by 0.5–0.75 mg/kg doses every 5–10 minutes, up to 3 mg/kg.
A patient achieves ROSC but remains unresponsive. What temperature-management strategy is mentioned in the course, and what temperature range should be maintained?
Targeted Temperature Management (TTM) should be initiated for 12–24 hours, maintaining a core temperature of 32–37.5°C.