Content in Advanced Life Support
Indicate the correct administration of adrenaline 1 mg in the following scenarios:
a) A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock.
b) A patient presents pulseless electrical activity after the first shock.
c) An unconscious patient with a palpable pulse of 40 bpm.
d) Patient suffers an anaphylactic reaction with shock and airway swelling.
A 40 year – old woman, previously fit and well and without cardiovascular risk factors, presents to A&E on San Valentine´s day, 1 hour after breaking up with her boyfriend, with chest pain and dyspnoea. ECG shows ST elevation. You suspect a Takotsubo cardiomyopathy. Which of the following are correct?:
a) Troponin will not be elevated.
b) This diagnosis will be confirmed via cardiac catheterization.
c) Takotsubo has been linked to near – drowning episodes.
d) Peak occurrence for Takotsubo is during the evening hours.
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.
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).
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