Question

You witness a middle-aged, obese male pedestrian collapse on an escalator in an airport. He is clutching his chest and slumps over on the person behind him. The bystander places him on the floor at the end of the down-moving escalator track. As a first responder certified in ACLS, which of the following is your first course of action?

A) Check the patient for head injury

B) Check the patient for spinal injury

C) Check for the pulse

D) start CPR

You start high-quality CPR at a rate of 100-120 compressions per minute. The AED arrives moments later. You open the man's shirt to find a copious amount of thick hair covering his chest and he is damp with sweat. The AED cannot get a good signal through the pads because of the hair, even though you have pressed them down very hard. What is your next action?

A) do not use the AED

B) raze the patient chest

C) rip the pads off the man's chest and apply new pads in the same location.

D) Apply the pads in a different area.

The pads are working properly and a shock is delivered. What is your first action now?

A) check for the pulse

B) try to wake up the patient

C ) resume high quality CPR

D) administers epinephrine

What is the recommended dosage of epinephrine during a cardiac arrest?

What does it mean check for H & T during a cardiac arrest ?

Answer 1

1.As a first responder certified in ACLS,move the patient from the escalator,send some one to get an AED and check for carotid pulse.

2.Rip the pads off the man's chest and apply new pads in the same location.

Chest hair interferes with the elctrical activity through the AED pads.The adhesive on the pads rip the chest hair out and new pads can be used on the bare skin.

3.Resume high quality CPR after the shock is delivered as this restores blood flow to the brain and heart and will help in the return of spontaneous circulation.

4.The recommended dose of epinephrine in cardiac arrest:

Intravenous/intraosseous route : 1mg (10ml,1:10000) every 3-5 minutes during resuscitation.Follow  each dose with 20 ml flush and elevate the arm for 10 -20 seconds

Continous infusion: Add 1 mg ( 1ml of a 1:1000 solution ) to 250 ml normal saline or D5W with initial infusion rate of 1 mcg/min.

5.H's in cardiac arrest:

• Hypovolemia
• Hydrogen ion acidosis
• Hyperkalemia
• Hypokalemia
• Hypothermia

T's in cardiac arrest:

• Toxins
• Tamponade ( cardiac)
• Thrombosis ( coronary and pulmonary)
• Trauma
• Tension pneumothorax