ACLS Megacode 2: BradycardiaHurry, don’t let time run out!Sorry, time is up!0 Hours 0 Minutes 0 SecondsStep 1 of 812%UntitledA 58-year-old female with history of hypertension and diabetes presents for evaluation of lightheadedness.Initial vitals:T: 36.5, BP: 140/70, R: 22 P: 34, O2: 100%1. What is your initial step in management?*Initiate IV, monitor, and gather historyProvide supplemental oxygenGive atropineStart epinephrine infusionWhile an IV is placed, the patient is attached to a monitor.You appreciate the following rhythm:2. What is the next step in management?*Adenosine 6mgAtropine 0.5mgTranscutaneously pace the patientSynchronized cardio versionYou give atropine without response in heart rate.Patient begins to feel more light-headed and feels like she is going to pace out. Rhythm strip remains unchanged. Repeat vitals demonstrate a thready pulse and BP: 70/30.3. What is your next step in management?*IntubateGive atropine, transcutaneous pacingInitiate CPRTransvenous pacingYou attempt to transcutaneously pace the patient but are unable to capture and patient remains persistently bradycardia and hypotensive.4. Which medication can be started for treatment?*Epinephrine 2-10mcg/minute infusionDiltiazem 5mg/hourAmiodarone, 150mg bolus over 10 minutesDobutamine 5mcg/kg/minuteYou are attempting transcutaneous pacing but the patient remains persistently bradycardic.You attempt dopamine infusion but patient remains bradycardia. The patient now has become completely unresponsive and you are unable to palpate a pulse.Rhythm strip demonstrates the following:5. What is the next step in management?*Give dopamineCardovertInitiate CPRDefibrillateYou continue CPR.On re-evaluation, the monitor demonstrates the following:6. What is your next step in management?*Check a pulseIV fluidsDefibrillateSynchronized cardio version7. Which of the following represents possible causes of PEA arrest?*Hypoxia, hypovolemiaPulmonary embolism, hyperthermiaSepsis, myocardial infarctionHypomagnesmia, hypocalcemiaThe patient regains a pulse.8. What is your next step in management?*Start dobutamineSend for cardiac catheterizationIntubate, admit to the ICUOxygenate appropriately, maintain perfusion, consider therapeutic hypothermia This iframe contains the logic required to handle Ajax powered Gravity Forms.
