ACLS Heartcode Exam (2025)

In cardiac arrest, when do you first introduce medical intervention? Which drug? - answer-after 2 rounds of CPR/shock after 2nd shock give 1 mg epinephrine every 3-5 minutes When do you introduce amiodarone during cardiac arrest? - answer-after the 3rd shock give 300 mg bolus of amiodarone if second dose is needed give 150mg as second dose what rhythms are shockable in cardiac arrest - answer-VF VT what rhythms are not shockable in cardiac arrest - answer-asystole PEA if you are in an unshockable rhythm arrest when do you give epi - answer-1mg epi every 3-5 minutes after 1st round of CPR what do you do after return of spontaneous circulation - answer-maintain O2 sat at 94% treat hypotension (fluids vasopressor) 12 lead EKG if in coma consider hypothermia if not in coma and ekg shows STEMI or AMI consider re-perfusion what are the 5 h's and 5 t's - answer-hypovolemia hypoxia hydrogen ion (acidosis) hypo/hyperkalemia hypothermia tension pneumothorax tamponade, cardiac toxins thrombosis, pulmonary thrombosis, coronary how do you treat non-symptomatic bradycardia - answer-monitor and observe what constitutes symptomatic bradycardia - answer-hypotension altered mental status signs of shock chest pain acute heart failure How do you treat symptomatic bradycardia - answer-1. give 0.5mg atropine every 3-5 mins to max of 3mg if that doesn't work try one of the following: transcutaneous pacing 2-10mcg/kg / minute dopamine infusion 2-10mcg/minute epinephrine infusion what is considered a tachycardia requiring treatment - answer-over 150 per minute when do you consider cardioversion - answer-if persistent tachycardia is causing: hypotension altered mental status signs of shock chest pain acute heart failure If persistent tachycardia does not present with symptoms, what do you need to consider - answer-wide QRS? greater than 0.12 seconds If persistent tachycardia without symptoms DOES have a wide QRS what to do? - answer-IV access and 12 lead if available 6mg adenosine followed by NS flush only IF regular and monomorphic consider anti-arrhythmic infusion: - 20-50mg/min procainamide (max 17mg/kg) - 150mg amiodarone over 10 minutes - 100mg sotalol over 5 minutes