ACLS Megacode 1: Ventricular RhythmsHurry, don’t let time run out!Sorry, time is up!0 Hours 0 Minutes 0 SecondsStep 1 of 1010%UntitledA 73-year-old, male presents to the emergency department feeling light-headed and complaining of chest pain.He appears diaphoretic and uncomfortable. Initial vitals:T: 35.7, P: 88, R: 30 BP: 180/100, O2: 93%1. What is your initial step in management?*Place patient on monitor, establish IV access, gather history and examine patient, provide supplemental oxygen, get an EKGImmediately activate Cath Lab and STEMI protocolInitiate compressionsGive a beta-blocker IV, oxygen, and monitor are applied. Patient’s vitals remain unchanged.Initial EKG demonstrates the following:2. What is your next step in management?*Give 0.4mg nitroglycerin and notify cardiology/Cath LabGive 50mg of metoprolol and notify cardiology/Cath LabGive 324mg of aspirin and notify cardiology/Cath LabGive atropine After giving aspirin, the patient still complains of chest pain and suddenly becomes unresponsive.The monitor demonstrates the following:3. What is your next step in management?*Give amiodaroneGive epinephrineCardiovert as soon as possibleDefibrillate as soon as possible 4. What Joules should be used for defibrillation with a monophonic defibrillator with a biphasic?*200J with monophasic, 300J with biphasic300J with monophonic, 200J with biphasic150J with monophasic, 300J with biphasic300J with monophonic, 300J with biphasic After initial defibrillation, condition is unchanged.5. What is the next step in management?*IntubationAtropineCPRCease efforts 6. What medications can be used to aid resuscitative efforts?*Epinephrine 1mg, every 3-5 minutesAdenosine 6mg, followed by 12 mg if initial dose is ineffectiveAmiodarone 150mg one timeAtropine 0.5 mg, every 3-5 minutes You defibrillate the patient, provide epinephrine and recheck a pulse. The patient remains pulseless.Rhythm demonstrates the following:7. What is your next step in management?*DefibrillateEpinephrineAmiodaroneCardiovert After defibrillation and another round of CPR, with administration of epinephrine, the monitor demonstrates the following:8. What is the next step in management?*Check a pulseCariovertDefibrillateCPR The patient has a faintly palpable pulse. Patient is hypotensive (70/40).Monitor demonstrates the following rhythm:9. What is the next step in management?*Administer amiodaroneSynchronized cardio versionDefibrillateStart epinephrine drip After synchronized cardioversion, patient’s blood pressure improves.He remains unresponsive, has shallow respirations with oxygen saturation of 90%. Pulse is palpable at 80. Blood pressure 100/60. EKG demonstrates persistent ST elevation.10. What is the next step in management?*Give nitroglycerinGive amiodaroneConsider intubation, send to cardiac catheterization for cardiac interventionAdmit to the intensive care unit This iframe contains the logic required to handle Ajax powered Gravity Forms.