Adult Resuscitation

ACLS

100

Which 2 rhythms are "shockable" 

Ventricular fibrillation

Pulseless Ventricular tachycardia

Bonus: How does the monitor know if there is a pulse? 

200

Minimum and maximum amount for time to feel for a pulse?

At least 5s, no more than 10s

300

What is the ventilation rate with an advanced airway in place during chest compressions?

10 breaths / min 

or 

1 breath every 6 seconds

Bonus: why?

400

What is the recommended compression fraction during cardiac arrest? 

*Time on the chest*

80%

500

List 5 of the 12 reversible causes of cardiac arrest. 

H's and T's

Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hyper-/hypokalemia, Hypoglycemia, Hypothermia.

Toxins, Tamponade(cardiac),Tension pneumothorax, Thrombosis (coronary and pulmonary), and Trauma.

Drugs of salvation

100

What is the dosing for epinephrine in cardiac arrest?

1mg q3-5 minutes

200

How much sodium is in 1amp of code-cart Sodium Bicarbonate (8.4%)? 

50mEq 

4.2g

84mg/mL

300

What is the first dose for amiodarone during CPR?

300mg

Bonus what is the second dose for lidocaine during CPR? 

400

What is one pharmacological cause of intra-resuscitation rise in ETCO₂

NaHCO₃ administration

Bonus: What other factors influence ETCO₂?

500

Dosing for Sodium bicarbonate in TCA overdose? 

1-2mEq/kg over 2-3 minutes

Put your back into it

100

What is the recommended range for compression rate?

100-120

Bonus: why?

200

AHA ACLS 2020 adult compression depth?

2 inches

or

5 centimeters

300

Name 1 tool used to objectively identify compressor fatigue

Real-time feedback device (slowing rate, decreased depth)

ETCO2 (down-trending EtCO2 below 20)

400

Name 2 of the 3 inciting mechanisms of arrest that are indications for prolonged CPR efforts? 

Lightning strike

Hypothermia

Drowning

500

What tool has been used in some institutions to visualize and guide external chest compressions?

Transesophageal echocardiography

TEE

You read the chapter

100

How quickly must VA-ECMO be initiated after initiation of CPR? 

60 minutes

OHCA with 11-33% survival rate *in select patients

200

What ScvO₂ threshold justifies termination of resuscitation efforts? 

<40%

100% PPV

Bonus: What is ScvO2 and how do you measure it?

300

What fraction of pre-hospital cardiac arrests achieve ROSC? 

+/- 5%

10%

400

What is the goal for coronary perfusion pressure during CPR? 

20mmHg

Bonus: What is the equation for CPP?

500

What fraction of in-hospital cardiac arrests achieve ROSC?

+/- 5%

26%

Beyond ACLS

100

Target MAP goals after ROSC?

70-100mmHg

200

Temperature range for hypothermic targeted temperature management (HTTM)?

32-36°C

Argue: does it work? 

300

What are the 2 types of sonographically discernible PEA. 

Electrical-Mechanical dissociation (EMD)

Pseudo-EMD

Bonus: lets learn some more about this...

400

What fraction of pre-hospital ROSC patients have occlusive coronary disease? 

+/- 5%

50%

500

What is the 1st line beta-blocker recommended to be given in conjunction with amiodarone in the setting of VT storm?

Propanolol 

IV: 1-3mg q5min Max 5mg

PO: 40mg q6h

Bonus: why?