Tachyarrhythmias in ALS

A 68 year – old man presents to A&E with sepsis. While you start monitoring, the patient becomes pulseless and unconscious. With reference to the rhythm strip:

a) The ventricular rate is in the range 150 – 200 per min.

b) DC shock is the most appropriate treatment.

c) Adenosine 6 mg iv over 2 min may reverse this arrhythmia.

d) Verapamil 5 mg iv may terminate this arrhythmia.

Fibrinolysis in ALS

A 55 year – old man on CCU due to a surgery for an aortic aneurism 4 weeks ago, has a witnessed, monitored cardiac arrest. The ECG previous to the cardiac arrest shows a ST elevation in anterior leads.  After 15 minutes of CPR you make the following decisions:

a) Fibrinolysis is contraindicated if the patient has had a surgical procedure within the last month.

b) Ongoing CPR for 15 minutes contraindicates the use of fibrinolysis.

c) If fibrinolysis is administerd, CPR shoud continue for another 45 minutes.

d) Fibrinolysis therapy is as effective as percutaneous coronary intervention (PCI).