EMS103 CHAP 21-25

Which of the following BEST describes an appropriate shock sequence for the patient in ventricular tachycardia?

• Shock, shock, shock, shock

• Shock, 2 minutes of CPR, reanalyze, shock again if indicated

• Shock, shock, shock, pulse check, 2 minutes of CPR, shock, shock, shock

• Shock, pulse check, shock, pulse check, shock, pulse check

Answer explanation

The correct sequence is 'Shock, 2 minutes of CPR, reanalyze, shock again if indicated' as it allows for effective CPR and reassessment, which is crucial in managing ventricular tachycardia.

Mechanical CPR devices are used by EMS agencies in order to provide:

• a faster response time to the scene.

• better quality of care with less training.

• a 100% success rate.

• high-quality compressions.

Answer explanation

Mechanical CPR devices are designed to deliver high-quality compressions consistently, which improves patient outcomes during cardiac arrest. This is the primary benefit they provide, making 'high-quality compressions' the correct answer.

You are on the scene of a 68-year-old male patient complaining of severe chest pain for the last 20 minutes. He has a previous history of myocardial infarction and states it feels "just like the last time." You have applied oxygen and assisted him in administering aspirin and nitroglycerin with no reduction in the chest pain. Your nearest facility is 5 minutes away, a Level III Trauma Center is 10 minutes away, and a hospital with cardiac catheterization capabilities is 20 minutes away. The patient is requesting to be transported to his cardiologist's hospital, which is 30 minutes away. Which hospital is the best destination?

• The trauma center

• The nearest facility

• The nearest hospital with cardiac catheterization

• The hospital the patient requests

Answer explanation

The nearest hospital with cardiac catheterization is the best choice as the patient has severe chest pain and a history of myocardial infarction. Timely access to cardiac care is crucial, making this facility the most appropriate destination.

You are on the scene of a 65-year-old female patient in cardiac arrest. CPR is in progress and the AED has been applied. The AED advises shock. After defibrillating the patient, what is your next intervention?

• Check for a pulse.

• Continue CPR.

• Insert a Combitube.

• Place in the recovery position.

Answer explanation

After defibrillation, the next step is to continue CPR for 2 minutes before reassessing. This helps maintain blood flow and increases the chances of successful resuscitation.

What does ventricular fibrillation do?

• Causes asphyxial cardiac arrest

• Initiates commotio cordis

• Forces the heartbeat to become quite rapid

• Prevents the heart muscle from contracting normally

Answer explanation

Ventricular fibrillation disrupts the heart's normal rhythm, preventing the heart muscle from contracting effectively. This leads to ineffective blood circulation and can result in cardiac arrest if not treated promptly.

If an EMT is tasked with managing the family of a patient who is deceased after termination of resuscitation, what is an effective care strategy?

• Prevent the family from seeing the deceased patient.

• Minimize the family's time with the deceased patient.

• Tell the family the EMT knows how they feel.

• Be straightforward and use direct language.

Answer explanation

Being straightforward and using direct language helps the family understand the situation clearly, providing them with the necessary information and support during a difficult time, rather than avoiding the reality of the loss.

You are the first on the scene of a 72-year-old patient in cardiac arrest. You have your medical supply kit, oxygen, and an AED. At least 4 to 5 minutes of high-quality CPR has been provided by the police officer who arrived before you. You have confirmed an open airway, apnea, and pulselessness. Which of the following should you do next?

• Apply the defibrillator pads and shock as indicated.

• Perform bag-valve mask ventilations with supplemental oxygen for 30 seconds before applying the defibrillator pads.

• Contact medical direction before taking any action.

• Perform one-rescuer CPR until additional personnel arrive.

Answer explanation

In this scenario, high-quality CPR has already been provided, and the patient is in cardiac arrest. The next step is to apply the defibrillator pads and deliver a shock if indicated, as this can restore a normal heart rhythm.

Once an EMT has begun resuscitative efforts, when may the EMT cease those efforts?

• The patient has no pulse after 1 minute.

• No other rescuer is available to relieve the EMT.

• Spontaneous circulation and breathing occur.

• The EMT's partner gives the order to cease.

Answer explanation

An EMT may cease resuscitative efforts when spontaneous circulation and breathing occur, indicating the patient is stabilizing. Other options do not provide valid reasons to stop efforts.

You are transporting a 50-year-old male patient whom you successfully defibrillated at the scene. You are 5 minutes away from the hospital when the patient goes back into cardiac arrest. Which of the following is the BEST course of action?

• Tell the driver to stop, analyze the cardiac rhythm, and deliver a shock as necessary.

• Tell the driver to stop and assist you with CPR, and request another unit for assistance.

• Analyze the cardiac rhythm and deliver shocks as necessary.

• Initiate CPR and continue transporting.

Answer explanation

Stopping to analyze the cardiac rhythm allows for immediate assessment and defibrillation if needed, which is crucial in a cardiac arrest situation. This choice prioritizes the patient's survival over continued transport.

Your patient is a 66-year-old female who has regained a pulse after a shock with an AED; however, she remains unresponsive and is not breathing adequately. Which of the following should be done next?

• Remove the AED, assist the patient's ventilations with a bag-valve mask and supplemental oxygen, and keep reassessing the pulse.

• Apply a nonrebreather mask with high-concentration oxygen and keep reassessing the pulse.

• Deliver a fourth shock to improve the patient's respiratory status.

• Ventilate the patient with high-concentration oxygen and transport immediately.

Answer explanation

Ventilating the patient with high-concentration oxygen is crucial since she is unresponsive and not breathing adequately. Immediate transport is also necessary to ensure she receives further medical care.