You are the code team leader and arrive to find a patient with above
rhythm and CPR in progress. Team members report that the patient
was well but reported chest pain and then collapsed. She has no
pulse or respirations. Bag-mask ventilations are producing visible
chest rise, high-quality CPR is in progress, and an IV has been
established. What would be your next order?
1. Administer atropine 1 mg.
2. Perform endotracheal intubation.
3. Start dopamine at 10 to 20 mcg/kg per minute.
4. Administer epinephrine 1 mg.
5. Administer amiodarone 300 mg.
Give this one a try later!
4. Administer epinephrine 1 mg.
,You are monitoring a patient. He suddenly has the persistent rhythm
shown below. You ask about symptoms and he reports that he has
mild palpitations, but otherwise he is clinically stable with unchanged
vital signs. What is your next action?
1. Give an immediate synchronized shock.
2. Give sedation and perform synchronized cardioversion.
3. Administer magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given
over 5 to 20 minutes.
4. Give an immediate unsynchronized shock.
5. Administer adenosine 6 mg; seek expert consultation.
Give this one a try later!
5. Administer adenosine 6 mg; seek expert consultation.
A patient in the emergency department develops recurrent chest
discomfort (8/10) suspicious for ischemia. His monitored rhythm
becomes irregular as seen above. Oxygen is being administered by
nasal cannula at 4 L/min, and an IV line is in place. Blood pressure is
160/96 mm Hg. There are no allergies or contraindications to any
medication. You would first order:
1. Sublingual nitroglycerin 0.4 mg.
2. Morphine sulfate 2 to 4 mg IV.
3. Lidocaine 1 mg/kg IV and infusion 2 mg/min.
4. Amiodarone 150 mg IV.
5. IV nitroglycerin initiated at 10 mcg/min and titrated to patient
response.
Give this one a try later!
1. Sublingual nitroglycerin 0.4 mg.
, A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine
have been given. Which is the next drug/dose to anticipate to administer?
1. Amiodarone 300 mg
2. Amiodarone 150 mg
3. Vasopressin 40 units
4. Epinephrine 3 mg
5. Lidocaine 0.5 mg/kg
Give this one a try later!
1. Amiodarone 300 mg
Identify the rhythm.
Give this one a try later!
Polymorphic ventricular tachycardia
A patient has been resuscitated from cardiac arrest and is being
prepared for transport. She is intubated and is receiving 100% oxygen.
Blood pressure is 80/60 mm Hg. During the resuscitation, she received
2 doses of epinephrine 1 mg and 1 does of amiodarone 300 mg IV. You
now observe this rhythm on the cardiac monitor. The rhythm
abnormality is becoming more frequent and increasing in number. You
should order:
1. Amiodarone 150 mg IV bolus; start infusion.
2. A repeat dose of epinephrine 1 mg IV.
rhythm and CPR in progress. Team members report that the patient
was well but reported chest pain and then collapsed. She has no
pulse or respirations. Bag-mask ventilations are producing visible
chest rise, high-quality CPR is in progress, and an IV has been
established. What would be your next order?
1. Administer atropine 1 mg.
2. Perform endotracheal intubation.
3. Start dopamine at 10 to 20 mcg/kg per minute.
4. Administer epinephrine 1 mg.
5. Administer amiodarone 300 mg.
Give this one a try later!
4. Administer epinephrine 1 mg.
,You are monitoring a patient. He suddenly has the persistent rhythm
shown below. You ask about symptoms and he reports that he has
mild palpitations, but otherwise he is clinically stable with unchanged
vital signs. What is your next action?
1. Give an immediate synchronized shock.
2. Give sedation and perform synchronized cardioversion.
3. Administer magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given
over 5 to 20 minutes.
4. Give an immediate unsynchronized shock.
5. Administer adenosine 6 mg; seek expert consultation.
Give this one a try later!
5. Administer adenosine 6 mg; seek expert consultation.
A patient in the emergency department develops recurrent chest
discomfort (8/10) suspicious for ischemia. His monitored rhythm
becomes irregular as seen above. Oxygen is being administered by
nasal cannula at 4 L/min, and an IV line is in place. Blood pressure is
160/96 mm Hg. There are no allergies or contraindications to any
medication. You would first order:
1. Sublingual nitroglycerin 0.4 mg.
2. Morphine sulfate 2 to 4 mg IV.
3. Lidocaine 1 mg/kg IV and infusion 2 mg/min.
4. Amiodarone 150 mg IV.
5. IV nitroglycerin initiated at 10 mcg/min and titrated to patient
response.
Give this one a try later!
1. Sublingual nitroglycerin 0.4 mg.
, A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine
have been given. Which is the next drug/dose to anticipate to administer?
1. Amiodarone 300 mg
2. Amiodarone 150 mg
3. Vasopressin 40 units
4. Epinephrine 3 mg
5. Lidocaine 0.5 mg/kg
Give this one a try later!
1. Amiodarone 300 mg
Identify the rhythm.
Give this one a try later!
Polymorphic ventricular tachycardia
A patient has been resuscitated from cardiac arrest and is being
prepared for transport. She is intubated and is receiving 100% oxygen.
Blood pressure is 80/60 mm Hg. During the resuscitation, she received
2 doses of epinephrine 1 mg and 1 does of amiodarone 300 mg IV. You
now observe this rhythm on the cardiac monitor. The rhythm
abnormality is becoming more frequent and increasing in number. You
should order:
1. Amiodarone 150 mg IV bolus; start infusion.
2. A repeat dose of epinephrine 1 mg IV.
