ACLS REVIEW QUESTIONS ANSWERS
WITH COMPLETE SOLUTIONS 100%
CORRECT!!!
STEMI Reperfusion Windows ✔️✔️
For patients presenting with ST-segment elevation myocardial infarction (STEMI)
who have no contraindications, the goal is to restore blood flow to the heart muscle
as quickly as possible.
The Window: Reperfusion therapy (either fibrinolytic "clot-busting" drugs
or percutaneous coronary intervention/PCI) is recommended for patients
whose symptoms started within the last 12 hours.
The Preference: If available, PCI is the preferred method, with a "door-to-
balloon" time goal of 90 minutes.
Explore
Mechanics of High-Quality CPR ✔️✔️
Quality CPR is the foundation of resuscitation. The following metrics are essential:
, Compression Depth: Push down at least 2 inches (5 cm) to effectively
pump the heart.
Recoil: Allow for complete chest expansion to ensure the heart refills with
blood.
Minimizing Gaps: Limit pauses (for rhythm checks or airway placement) to
less than 10 seconds.
Rotation: Swap compressors every 2 minutes (or sooner if tired). The
transition should be seamless, ideally taking 5 seconds or less.
Ventilation Volume: Give just enough air to see the chest rise; avoid
excessive ventilation to prevent increased intrathoracic pressure.
The Assessment Process: Initial Impression ✔️✔️
The very first step in the systematic approach is the Initial Impression. This is a
"doorway" assessment where you look at the patient’s consciousness, breathing,
and skin color before even touching them. This quick scan determines if the patient
is "sick or not sick" and whether you should move immediately to the BLS or
ACLS survey.
Perfusion Pressure and Survival ✔️✔️
Every time chest compressions stop, the Coronary Perfusion Pressure (CPP)—
the pressure that drives oxygenated blood into the heart’s own arteries—drops
rapidly.
Impact: It takes several consistent compressions to build that pressure back
up to a level that can support a return of spontaneous circulation (ROSC).
Frequent interruptions keep the CPP too low to sustain life.
Nitroglycerin Contraindications ✔️✔️
Beyond the use of phosphodiesterase inhibitors (ED medications), a major clinical
contraindication for nitroglycerin is a confirmed right ventricular (RV)
infarction.
The Danger: Patients with RV infarctions are highly "preload dependent."
Because nitroglycerin is a potent vasodilator, it reduces the amount of blood
returning to the heart. In an RV infarct, this can cause a catastrophic and
sudden drop in blood pressure.
Which are the elements of a system of care?
Structure, processes, system, patient outcome
WITH COMPLETE SOLUTIONS 100%
CORRECT!!!
STEMI Reperfusion Windows ✔️✔️
For patients presenting with ST-segment elevation myocardial infarction (STEMI)
who have no contraindications, the goal is to restore blood flow to the heart muscle
as quickly as possible.
The Window: Reperfusion therapy (either fibrinolytic "clot-busting" drugs
or percutaneous coronary intervention/PCI) is recommended for patients
whose symptoms started within the last 12 hours.
The Preference: If available, PCI is the preferred method, with a "door-to-
balloon" time goal of 90 minutes.
Explore
Mechanics of High-Quality CPR ✔️✔️
Quality CPR is the foundation of resuscitation. The following metrics are essential:
, Compression Depth: Push down at least 2 inches (5 cm) to effectively
pump the heart.
Recoil: Allow for complete chest expansion to ensure the heart refills with
blood.
Minimizing Gaps: Limit pauses (for rhythm checks or airway placement) to
less than 10 seconds.
Rotation: Swap compressors every 2 minutes (or sooner if tired). The
transition should be seamless, ideally taking 5 seconds or less.
Ventilation Volume: Give just enough air to see the chest rise; avoid
excessive ventilation to prevent increased intrathoracic pressure.
The Assessment Process: Initial Impression ✔️✔️
The very first step in the systematic approach is the Initial Impression. This is a
"doorway" assessment where you look at the patient’s consciousness, breathing,
and skin color before even touching them. This quick scan determines if the patient
is "sick or not sick" and whether you should move immediately to the BLS or
ACLS survey.
Perfusion Pressure and Survival ✔️✔️
Every time chest compressions stop, the Coronary Perfusion Pressure (CPP)—
the pressure that drives oxygenated blood into the heart’s own arteries—drops
rapidly.
Impact: It takes several consistent compressions to build that pressure back
up to a level that can support a return of spontaneous circulation (ROSC).
Frequent interruptions keep the CPP too low to sustain life.
Nitroglycerin Contraindications ✔️✔️
Beyond the use of phosphodiesterase inhibitors (ED medications), a major clinical
contraindication for nitroglycerin is a confirmed right ventricular (RV)
infarction.
The Danger: Patients with RV infarctions are highly "preload dependent."
Because nitroglycerin is a potent vasodilator, it reduces the amount of blood
returning to the heart. In an RV infarct, this can cause a catastrophic and
sudden drop in blood pressure.
Which are the elements of a system of care?
Structure, processes, system, patient outcome
