This ACLS Quiz focuses on the bradycardia algorithm of the ACLS Protocol.
There are 10 questions to answer. Your quiz will be graded after completion.
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Question 1 of 11
1. Question
For transcutaneous pacing, the current milliamperes (mA) output should be:
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Question 2 of 11
2. Question
For transcutaneous pacing, the demand rate should be set at:
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Question 3 of 11
3. Question
After initiating external pacing, you should assess the carotid pulse to confirm mechanical capture.
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Question 4 of 11
4. Question
Preparation for transcutaneous pacing (standby pacing) should be made for which of the following?
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Question 5 of 11
5. Question
What is the infusion rate for epinephrine in the bradycardia algorithm?
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Question 6 of 11
6. Question
If transcutaneous pacing and drugs fail, what would be your next intervention?
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Question 7 of 11
7. Question
The following rhythm is complete block. Which definition of complete block is correct.
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Question 8 of 11
8. Question
Identify the following rhythm.
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Question 9 of 11
9. Question
Which of the following is not correct?
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Question 10 of 11
10. Question
Transcutaneous pacing is contraindicated in the patient with ________________.
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Question 11 of 11
11. Question
(True or False) Patients with ACS should be paced at the lowest heart rate that allows clinical stability.
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johnsa07 says
So the order is atropine if it dont work then TCP if TCP dont work then Dopamine if dopamine dont work then epinephrine?
Jeff with admin. says
This is correct except dopamine and epinephrine are both considered equally effective for pacing. This means that either could be attempted first and if it did not help then you could attempt the other.
Kind regards,
Jeff
Sandy Picchiottino says
Whats the difference between transcutaneous pacing and transvenous pacing. Thanks
Jeff with admin. says
Transcutaneous pacing is performed by placing pads on top of the skin (transcutaneous). These pads conduct an electrical current that stimulate the heart to contract.
Transvenous pacing is usually performed when transcutaneous pacing fails. This this case, electrodes are placed into the central venous system in much the same way as a central line is placed. These electrodes produce an electrical current that stimulate the heart to contract.
Transvenous pacing is a temporary procedure that is performed until a permanent pacemaker can be placed.
Here is a video that demonstrates placement of a transvenous pacemaker if you are interested.
Kind regards,
Jeff
folukefashakin@gmail.com says
hello jeff. who perform this placement of the transvenous pacemaker ? a surgeon or ACLS certified person. i asked this question because I am a RN just out of curiousity
Jeff with admin. says
Any physician that has been trained in the placement of a temporary transvenous pacemaker can perform this procedure.
The placement of a permanent pacemaker is performed by a surgeon.
Kind regards,
Jeff
rcastello says
Question 4: I thought TCP should not be used for all of the above choices.
Jeff with admin. says
Hi rcastelllo
Thanks for the question.
You asked:
“Question 4: I thought TCP should not be used for all of the above choices.”
Reply:
Asystole is the only thing that was contraindicated in the answers to question #4.
Both second degree heart block and complete heart block can be treated with transcutaneous pacing.
Kind regards,
Jeff
MCKINNEY says
The entire bradycardia section was great.I felt good after going over this section.I love the idea you can take the test,go over the rational,retake the test and come out feeling good about the subject matter,once again THX
Yasmn02 says
Awesome site, thanks a lot, ACLS was a breeze.
yolanda says
what is transvenous pacing
Jeff with admin. says
This is a basic article about Transvenous Pacing.
taniandra12@gmail.com says
I am confused with the epinephrine dosage for bradycardia ( question 6 ) . According to the tip on cramming meds for Bradycardia you give 1 mg Epi, but the answer to the question mentioned above is 2 to 10 mcg/min. Can you explain why? Thank’s.
Jeff with admin. says
In the bradycardia algorithm, epinephrine is only used as an infusion only. This infusion is meant to increase the heart rate.
In the pulseless arrest algorithm, epinephrine is used as an IV push. This is meant to help increase blood pressure.
You stated “According to the tip on cramming meds for bradycardia you give 1mg epi.” I’m not sure where you saw this, but there is nothing on this site in the bradycardia section that says this. 1mg doses of epinephrine are used only in the pulseless arrest algorithm.
Please let me know if you have any other questions.
Kind regards,
Jeff
dbrumba says
On # 7 it appears the rate is 75 at best , but > 65, why is this strip not exhibiting sinus rhythm, and why is it considered sinus bradycardia? Is not bradycardia a rate < 60 ?
Jeff with admin. says
This rhythm strip is a slightly modified image from this image.
The rate is in the high 30’s. It is considered sinus bradycardia because the PR interval is normal and there is a p-wave generated with each QRS. When each electrical impulse is transmitted properly from the sinus node through the heart the bradycardia is considered sinus and is called sinus bradycardia.
Kind regards,
Jeff
dbrumba says
Now that I put on my glasses and viewed the other image, I see my mistake, thanks Jeff.
Dr Ghazwan says
Hello Jeff
why TCP is contraindicated in severe hypothermia ?
Jeff with admin. says
When the patient is in a hypothermic state electrical conduction across the cell membrane is greatly inhibited. TCP has not been shown to be effective for bradycardia related to hypothermia. The problem of bradycardia in a hypothermic state is best corrected by instituting rewarming measures.
Kind regards,
Jeff
rhuzavril says
Gudmorning’if atrophine’tcp & transvenous pacing failed what is the best to do?seek expert opinion or start dopamine infusion???..this just made me confius’..tnx!
Jeff with admin. says
You would start and epinephrine or dopamine infusion per ACLS protocol. If these fail, you would need get someone to place a transvenous line for transvenous pacing and consult for pacemaker placement.
Kind regards,
Jeff
mamccarra says
Is the dosing of epi 1-5mcg/min or 2-10mcg/min?
Jeff with admin. says
The dosing for Epinephrine used as a replacement for transcutaneous pacing is 2-10 mcg/min.
Kind regards,
Jeff
gena foucek sinopoli says
Jeff,
I have taught and worked as a nurse and artist for 34 years and feel this
is the best teaching site I have seen
Your site is awsome
gena
wingman03 says
jeff i though in question #5 tco is contraindicated in sinus brady?
Jeff with admin. says
There are cases where TCP would be appropriate for sinus bradycardia. For instance you may have a patient that has taken an overdose of a medication that slows heart rate and now they are unstable due to the effects of the medication. You could appropriately use TCP for the treatment of this unstable sinus bradycardia.
Kind regards,
Jeff
uefa1978 says
Are EKGs heavily tested on this exam??
Jeff with admin. says
Knowing the basics of EKG’S and rhythm interpretation will be mostly important fir the megacode skills station, but there may be a question or two on the written test.
Kind regards,
Jeff
Nicholas Sines says
This site is the bombiddydizzle!