AHA ACLS (New 2020 Guidelines) Quiz

1. What is the first dose of atropine for bradycardia?

2. A patient is found unresponsive in the following rhythm:

After initiating high-quality CPR, what is the most important next step?

3. A patient is found in the following rhythm:

His blood pressure is 78/50, he complains that he is nauseous and diaphoretic. After a complete assessment of the patient, which action should occur next?

4. The newest 2020 AHA ACLS Guidelines recommend pre-charging the defibrillator 15 seconds prior to the rhythm check. Why is this important?

5. A 55-year old male is found to be in the following rhythm:

He is awake, alert, and oriented with a blood pressure of 130/80. He denies chest pain or shortness of breath. After obtaining an EKG, what is your next initial treatment?

7. A patient who has just achieved return of spontaneous circulation (ROSC) is not responsive to commands. What is a priority consideration?

8. A patient in cardiac arrest is being resuscitated. After the second defibrillation attempt, a patient received their first dose of epinephrine. Two minutes later, the patient remains in ventricular fibrillation. What is the next appropriate medication?

9. Immediately after defibrillation, what is the next action that should be performed?

10. In addition to ensuring adequate high-quality CPR is being performed, what is another reason for using quantitative waveform capnography during a resuscitation attempt?

Return to post

Try again!

CORRECT!

The first dose of Atropine for bradycardia is
1 mg. The initial starting dose was increased from 0.5mg to 1mg with the release
of the new AHA 2020
Guidelines.

CORRECT!

The initial treatment for ventricular fibrillation is high-quality CPR and defibrillation. Remember, in
V-FIB, you D-FIB!

CORRECT!

First identify the rhythm (V-Tach), then determine if they are stable or unstable. Because their blood pressure is 78/50, they are unstable. The priority treatment for unstable patients is always to skip
straight to electricity which in
this case is
synchronized cardioversion.

CORRECT!

The newest recommendations from the 2020 AHA Guidelines indicate that precharging the defibrillator by 15 seconds results in an increase in chest compression fraction (CCF) which is the percentage of time that chest compressions are being performed during a resuscitation attempt. The goal is a CCF of
greater than 80%.

CORRECT!

The patient is in stable SVT. Stable patients should be treated with least invasive methods first. For SVT, the first thing we can try is vagal maneuvers.
If unsuccessful, we would try
medications (adenosine 6mg, then adenosine 12mg), then synchronized cardioversion.

CORRECT!

Closed loop communication can also be thought of as “repeat-back”. If the order is correct, you would repeat back the order you just received to “close the loop” and make sure that you heard it correctly. In this case, the order was incorrect since amiodarone 600 mg is too high of a dose,
so we should question it by
respectfully asking for clarification
of the order.

CORRECT!

Targeted temperature management (TTM) is a priority consideration for a patient that has just achieved ROSC and is unresponsive to verbal commands) in order to protect the brain and other vital organs. This is also sometimes referred to as “therapeutic hypothermia” or “code cool”. The correct temperature for
TTM is 32 – 36 degrees Celsius
for at least 24 hours.

CORRECT!

For ventricular fibrillation, the patient should receive two defibrillation attempts prior to giving any medication. The first medication to be given is epinephrine 1mg, followed by an antiarrhythmic during the next cycle, either amiodarone or
lidocaine. The first dose of amiodarone
is 300 mg and the first dose of
lidocaine is 1 – 1.5 mg/kg.

CORRECT!

Immediately after defibrillation, CPR should be resumed. We only analyze the rhythm every 2 minutes (or if they there is an indication of the patient achieving ROSC) which was already done immediately prior to defibrillation. Epineprhine is
administered every 3-5 minutes, not immediately after each defibrillation.
TTM would not be started during a resuscitation attempt.

CORRECT!

Using quantitative waveform capnography is recommended by the AHA as the best method for determining and monitoring
the correct placement of the
endotracheal tube,
ensuring high-quality CPR quality,
and identifying ROSC.