ACLS Megacode 1 In-Hospital Sorry, time is up! 0 Hours 0 Minutes 0 SecondsHurry, don't let time run out! Step 1 of 10 10% Untitled You are interning at a nearby hospital. Upon entering the hospital room of a 25-year-old male who was admitted the previous evening for chronic abdominal pain and a history of gastrointestinal ulcers, you find them unresponsive, lying in bed. On the table next to the bed is a half-eaten sandwich, so you assume he was eating shortly before. A rapid initial assessment reveals the following: Vital signs Pulse rate, Blood pressure, Respiratory rate, Temperature: Unobtainable Physiological systems Integumentary: Moist, cool Cardiovascular: No palpable pulse Respiratory: Visible chest rising, no audible respirations Neurological: Unresponsive 1. After conducting an initial assessment, it is determined that the patient is in cardiac arrest so you activate the Code Team. Given IV access has been established and a cardiac monitor is not attached to the patient, what are your initial actions?* Administer 1 mg IVP epinephrine Deliver one 120 J unsynchronized shock Check for airway obstruction without beginning CPR Begin with 5 cycles of CPR CPR has been initiated and the Code Team is arriving to the hospital room. 2. Which of the listed drugs should be considered for administration?* 1 mcg/kg Dopamine 1 mg IV/IO Atropine 20 mcg/kg/min Dopamine IV fluid bolus 1 mg IV/IO Epinephrine Five cycles of CPR have been performed, the patient received 1.0 mg of epinephrine via IVP and a cardiac monitor has been connected. A large amount of food was cleared from the patient's airway while performing CPR. After the completion of five CPR cycles, the cardiac rhythm check showed pulseless electrical activity. 3. What is your next step in management?* Pneumothorax with tension Cardiac tamponade Hypoxia (lack of oxygen) Acidosis (excess hydrogen ions) Another five cycles of CPR are performed. After completing these cycles, a check of the cardiac rhythm shows that pulseless electrical activity remains unchanged. 4. What do you do next?* Give 300 mg of amiodarone via IVP Provide a 120 J unsynchronized shock Give 1 mg of epinephrine via IVP Resume CPR for five cycles A 120 J unsynchronized shock is administered, and another five cycles of CPR are performed. After completing these cycles, a check of the cardiac rhythm shows that the ventricular tachycardia remains unchanged. 5. What do you do next?* Give 6 mg of adenosine via IVP Provide a 120 J unsynchronized shock Resume CPR for five cycles Administer 1 mg of epinephrine via IVP Another five cycles of CPR are performed. After completing these cycles, a check of the cardiac rhythm shows that there has been a transition from pulseless electrical activity to ventricular tachycardia. 6. What do you do next?* Provide a 200 J unsynchronized shock Administer 1 mg of atropine via IVP Administer 300 mg of amiodarone via IVP Administer 1 mg of epinephrine via IVP A 200 J unsynchronized shock is administered and another five cycles of CPR are performed. 7. After defibrillation, which of the following drug options should be considered during the first round of CPR?* Give 1.0 mg of epinephrine via IVP Administer 1.0-1.5 mg/kg of lidocaine via IVP Administer 300 mg of amiodarone via IVP Give 1.0 mg of atropine via IVP Epinephrine 1 mg IVP is administered while simultaneously continuing CPR. 8. What is the next step recommended by the AHA ACLS guidelines after administering any drug during cardiac arrest?* Flush the IV line with 20 ml of normal saline Flush the IV line with 10 ml of normal saline Check for a pulse Check for a cardiac rhythm Another five cycles of CPR are performed. After completing these cycles, a check of the cardiac rhythm shows that the ventricular tachycardia remains unchanged. A 300 Joules unsynchronized shock is administered and another five cycles of CPR are performed. 9. Which drug and dosage are recommended for the current situation?* Administer 1.5 mg of epinephrine via IVP Give 150 mg of amiodarone via IVP Administer 300 mg of amiodarone via IVP Administer 2-10 mcg/kg/min of dopamine via IVP 300 mg of amiodarone is given via IVP and another five cycles of CPR are performed. After completing these cycles, a check of the cardiac rhythm shows a transition from ventricular tachycardia to sinus tachycardia. A weak and faint pulse is detected during a pulse check. Vital signs are 162 bpm heart rate, 108/64 mmHg blood pressure. The patient is not breathing spontaneously and remains unconscious. 10. What do you do next?* Take the patient to the intensive care unit Monitor for low blood pressure (hypotension) and inadequate blood flow symptoms Consult an expert Insert an advanced airway and provide breathing assistance with a bag-valve-mask device.
