ACLS Megacode Simulator 1

 


ACLS Megacode Simulator 1

In this ACLS Megacode scenario, use the appropriate ACLS algorithms to treat the patient. There are 12 questions for this ACLS megacode scenario. Assume the use of biphasic defibrillator in all scenarios.

A 40 year old man arrives at the ER accompanied by his family. He is complaining of palpitations after working outside for several hours. The assessment is as follows:

SKIN: Hydrated, pale, warm and dry
CVS: Strong peripheral pulses and a BP of 125/80
CNS: Fully intact
RESP: RR is 22, no resp. difficulties, lungs CTA
The monitor shows narrow complex SVT with a HR of 180.

1. You place o2 at 2L by NC on the patient and start an IV. The monitor continues to show a narrow complex SVT

What is your next intervention?






2. You have performed vagal maneuvers and there is no change in the patients heart rate and rhythm. What is your next step?





3. You give 6mg Adenosine rapid IV push with no effect. 12mg Adenosine rapid IV push is then given. The patient develops severe chest pain and his vital signs are: HR 220, BP (not obtainable), and weak pulse. The patient also has LOC changes. Your next step should be.





4. After synchronized cardioversion is unsuccessful, the pt. continues to deteriorate. The patient is now unconscious with pusleless ventricular tachycardia. Below is what you see on the monitor:

What is your first intervention.






5. The patient does not respond to the defibrillation with 120 J. He remains unconscious in ventricular tachycardia. What is your next intervention





6. After completing 5 cycles of CPR, your rhythm check indicates a second shock. You shock a second time with 160 J, and the patient's rhythm does not change. You resume CPR. While completing the cycle of CPR what else should be done?





7. You have given the epinephrine or vasopressin and completed the 5 cycles of CPR. A rhythm check reveals no change. You attempt at third defibrillation. What will be your defibrillator setting?





8. The third shock does not change the rhythm and you restart CPR (5 cycles). You have shocked, you have given vasopressors (epinephrine and/or vasopressin), you have continued with effective CPR. What medication should be considered at this point?





9. What is the correct dosing for amiodarone in the Pulseless Arrest Algorithm?





10. Lidocaine can be used instead of amiodarone as an antiarrhythmic for pulseless arrest. What is the proper dosing of lidocaine?





11. You give amiodarone 300 mg first dose and the patient converts to a Normal Sinus Rhythm. You are instructed to start an amiodarone drip for the postresuscitation maintenance therapy. What is maximum cumulative dose for amiodarone in a 24 hour period?





12. Great Job! You saved the patient He has been stabilized and intubated, but does not respond to verbal commands. He is transported to the hospital's ICU. Since the patient is not responsive what would be the most important intervention in the post-cardiac arrest phase.







  296 Responses to “ACLS Megacode Simulator 1”

  1. FDWhitey says:
    May 19, 2013 at 4:10 pm

    Very nice site. I suggest it to my paramedic students to prepare for their megacode testing.

    One suggestion – keep in mind the “manufacturer recommendations” for defibrillation. Have a specific number for defib without the monitor type is a little difficult to answer.

    Thank you for your site!

    Reply
  2. vida frempong- boakye says:
    May 17, 2013 at 7:08 am

    Thanks very much for the update.I will highly recommend this exercise for beginners

    Reply
  3. raed says:
    May 13, 2013 at 9:26 am

    Thank you!!!! Very helpful!

    Reply
  4. E. Hill says:
    May 12, 2013 at 5:36 am

    Simple, easy to follow and user friendly!

    Reply
    • E. Hill says:
      May 12, 2013 at 5:51 am

      I answered the questions without reviewing check how much knowledge I have after no practice and use since 2002. I will highly recommend this for ACLS takers.

      Reply
  5. Mariana says:
    May 6, 2013 at 9:56 pm

    I am taking my ACLS course this weekend and this has been a very helpful site. I loved it.
    it is so much to remember, but i wish i can come back to this site in the future for review.

    Reply
  6. waynepsych says:
    May 5, 2013 at 9:10 pm

    How long do you have to wait between the first Adenosine IV push and the second one?

    Reply
  7. Jo Hobaugh says:
    May 3, 2013 at 9:52 pm

    why therapeutic hypothemia

    Reply
    • Jeff with admin. says:
      May 4, 2013 at 12:49 pm

      In the post arrest phase once ROSC is established but the pt. does not follow commands, it is recommended that therapeutic hypothermia be initiated. See page 77 of the AHA ACLS provider manual.

      Kind Regards,
      Jeff

      Reply
  8. monica says:
    May 1, 2013 at 5:10 pm

    Thank you!!!! Very helpful!

    Reply
  9. Muhammad Kamal Abouhajar says:
    April 30, 2013 at 9:36 am

    VERU USEFUL

    Reply
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