Acls Megacode Scenario 4

Front 1

A 52 year woman with a history of hypertension and type II diabetes presents to the ER complaining of chest pain for the past hour, radiating into her jaw. She complains of shortness of breath. The patient is placed on a cardiac monitor.

Evaluation:

* Skin: clammy and diaphoretic
* CV: regular rate and rhythm without audible murmurs, rub or gallop
* CNS: alert and oriented x 4, but appears uncomfortable and anxious.

1. Identify the rhythm:

Back 1

NSR with pvc unifocal

Front 2

Your immediate intervention is:

Back 2

obtain 12 leak ekg

Front 3

While you are starting the IV, the patient vomits and collapses. The monitor reveals this rhythm:

Back 3

begin cpr

Front 4

After shocking the patient with 120 Joules utilizing a biphasic monitor, you should next:

Back 4

give cpr

Front 5

After repeating CPR, the monitor continues to show v-fib. What is your next intervention?

Back 5

shock at 120-200j

Front 6

The dosage of 120-200 J is given by the defibrillator preferred by the AHA. This type of defibrillator is:

Back 6

biphasic

Front 7

In ACLS, what action immediately follows each shock?

Back 7

CPR

Front 8

Your next consideration after CPR, in light of the continuing v-fib on the monitor, should now be:

Back 8

epinephrine 1 mg IV

Front 9

You have given 1 mg epinephrine IV. How often can you repeat this dose?

Back 9

every 3-5 min

Front 10

What other medication can replace the first dose of epinephrine?

Back 10

vasopressin 40 units

Front 11

After giving the epinephrine, what is your next intervention?

Back 11

continue CPR

Front 12

After completing administration of epinephrine and the 5 cycles of CPR, what is your next intervention?

Back 12

check rhythm

Front 13

The patient remains pulseless, but now has the following rhythm:

What is your next intervention?

Back 13

shock

Front 14

The patient remains in pulseless v-tach after a shock of 200 J. You should:

Back 14

consider amiodarone

Front 15

You have given one dose of amiodarone during this code. You are ready to give another dose. What is the correct dosage?

Back 15

150 mg

Front 16

After repeating amiodarone and completing 5 cycles of CPR, you see the following rhythm:

Back 16

5 cycles of CPR

Front 17

You have successfully intubated your patient. There was minimal interruption in CPR. You gave 1 mg. epinephrine during intubation. The rhythm strip is below:

What is the rhythm?

Back 17

ventricular fibrillation

Front 18

What is your next action?

Back 18

shock

Front 19

The patient has return of spontaneous circulation, with a blood pressure of 90/60, with no spontaneous breathing. The patient is hooked to the ventilator. The rhythm strip reveals:

Back 19

amiodarone infusion

Front 20

Identify the rhythm:

Back 20

first degree AV block