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.
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mamckee24 says
Wow. Read the ACLS book from beginning to end and wondered how I was ever going to remember any of it. Friend from work recommended this site and am so grateful. So much easier to understand in this format. Thanks so much!
currell says
I agree! Actually makes the whole process interesting, rather than dry!
Dr Harbhajan Singh says
Very informative and makes ACLS easy.
tylah434@yahoo.com says
thanx a million
Elizabeth Zabala says
I am thankful for this web to have some scenarios and help me much
sandroidex says
I love it a lot. I am a new grad nurse and I took an ACLS course. I thought it’s going to be easy but it was hard and when I found your site, I was so happy. It help me a lot.
Andy Valdez says
I have a megacode test coming up at work and this site has helped me heaps. Thanks for the work you put into this. It was fun, helpful and well organized.
Linda G. Davis says
Jeff,
I have been a nurse for over 35 years and have taken ACLS many,many times.This Program has been the best resource I have ever used. It was so much easier just studying from your site than using the book,The test questions were very helpful as well as the rhythm strips.You covered all the new ACLS changes.(we didn’t even have the new edition.)I will have to renew 1 more time(2018) before retirement I saved the website on my computer.I need you to stay around until then.
Jeff with admin. says
Thanks so much for the encouragement. I’m so glad that the site was hope for you. Kind regards,
Jeff
Mary A says
The confusion with this question is the question states PULSELESS, but having V tach. I read that as PEA, which would indicate CPR. That is the reason why I did not choose unsynchronized cardio.
Jeff with admin. says
Pulseless VT is treated using the left branch of the Cardiac Arrest Algorithm which would call for shocks. Pulseless VT is not treated as PEA even though it is technically a type of PEA.
Treat Pulseless VT and VF with the left branch of the cardiac arrest algorithm.
Kind regards,Jeff
hugo ripoll says
I thought that you synchronize right away when pt is unstable.. since pt has palpitations..isn’t that unstable?
Jeff with admin. says
Palpitations do not indicate an unstable state. Serious signs and symptoms commonly seen with unstable tachycardia are: chest pain, signs of shock, SOA (short of air), altered mental status, weakness, fatigue, and syncope.
lindajane says
I think I am getting it and then I get confused…when do you use the VT algorithm on the left side of the cardiac arrest page or the tachycardia algorithm?
In question 3 of 12 the answer is: perform immediate synchronized cardioversion.
The other option was defibrillation. I still get confused on how to differentiate. Help me to understand this better. I have reviewed your synchronized and unsynchronized sheet but I am still confused.
Jeff with admin. says
Left branch of cardiac arrest algorithm = pulseless VT
Tachycardia algorithm = any tachycardia that has a pulse
Kind regards,
Jeff
lindajane says
Is it assumed that you gave five cycles of CPR in between the synchronized and unsynchronized cardioversion? Else for this answer, I would have given the five cycles of CPR because the patient was without perfusion and we need to get blood flow. This wants you to go from synchronized, then unsynchronized… just wondering.
Jeff with admin. says
If there is a change in the rhythm to from perfusing rhythm to cardiac arrest and this is witnessed, the first and most important intervention should be defibrillation. Early defibrillation is key to improving ROSC and improving survival to hospital discharge. After the defibrillation CPR should begin immediately while the heart begins to pump again. Kind regards, Jeff
fawnfatale says
I wish we could hit previous when doing the megacode simulator practice questions, sometimes I get interrupted and want to see what I just did etc. Really any part of this website that has a next button, a previous button would be appreciated. Thanks a bunch!
Jeff with admin. says
I am working to incorporate this feature into the site on all of the practice tests and megacode scenarios. This feature should be fully deployed within the next 2 months. Thanks for the suggestion!
Kind regards,
Jeff
leilarocks says
I’m really impressed that you have already updated your info to reflect the 2015-2020 changes!! Such a great site! 3rd year that I’ve used your site to prepare for my ACLS! Thank-you!!
Janhoop says
I’m looking forward for my re-certification. I know I will pass. Thanks to you Jeff. Jan
Jeff with admin. says
So glad the site has been helpful for you! Thanks for the encouragement. Kind regards, Jeff
graydongrey says
I’m curious regarding question 7 with respect to the energy dosage with the 3’d attempt at defibrillation. Before answering question 7, we are now told to assume the biphasic defibrillator shock setting can range from 50 – 360 J. The correct answer to question 7 is 300 J. With question 6, the 2nd shock given was @ 200 J, the first shock was @120 J.
On pg 61 of the ACLS book under Shock Energy, Biphasic states: Manufacturer recommendation ( eg., initial dose of 120 – 200 J); if unknown use maximum available. Second and subsequent doses should be “equivalent”, and higher doses “may” be considered. So, why would the 3’d attempt not be at 200?
Thanks so much, love the course content.
Jeff with admin. says
The recommendation of 120-200 J is for the initial shock dose. This recommendation is for the first shock dose. After the initial shock dose, the dosing should be done on a gradual increasing increment. 120, 200, 300, and 360 J.
Kind regards,
Jeff
Joanna Zarzycki says
This is the first time I’ve ever heard 360 J Biphasic. I’ve always been taught 200 J Biphasic and 360 Monophasic. This isn’t correct??
Jeff with admin. says
Some models of biphasic defibrillators do have shock dose settings that go to 360 J. Kind regards, Jeff
Lukeson says
Man,,, This was awesome. Though I was not a trained personal with such skills for ACLS, I still managed to get some of the answers right and that pleases me a lot.
I think I will sit back and do a lot of studies to get them all right by the next time come to try this.
thanks a lot to the producers
Lukeson
MERLE M SIMPSON RRT, TCF says
THE AMOUNT OF JOULES USED FOR DEFIBRILLATION IS DEPENDENT ON THE TYPE OF DEFIBRILLATOR YOU ARE USING THE PROPER SHOCK DOSE IS PRINTED ON THE TOP OF THE DEFIBRILLATOR ABOVE THE POWER BUTTON