Scenario Data: You find an 67 year old female unconscious and “down” in the hospital hallway floor.

Your Initial quick assessment reveals:

Skin: Cyanotic/Clammy/Cool
Cardio: No pulses
Resp: No respirations
CNS: No response

You come upon the above patient and you assess that the patient is unresponsive with no respirations, and no pulse. What will be your first intervention?

You have called for help and a defibrillator and 2 coworkers are now available on scene. What is your next intervention?

The patient has NO DNR wrist band so you begin CPR performing chest compressions while your coworker is maintaining the patient’s airway. Shortly, the crash cart arrives with a BVM and a defibrillator. Your coworker begins giving ventilations with the BVM/O2 as you perform chest compressions. What is the correct compression to ventilation (BVM) ratio for 2 man CPR?

Since the crash cart has arrived, what is your next step?

A team member attaches the defibrillator/monitor to the patient. This is what you see on the monitor:

What is the rhythm?

You identify the rhythm as ventricular fibrillation. What should you do now?

Before shocking a patient, which choice below is correct?

You state “I’m clear, you're clear, everybody’s clear!” Make a visual check and then shock with 120 J. What is your next intervention after the shock?

You provide 5 cycles of CPR. What is the next intervention?

Your rhythm check shows the following rhythm.

What is your next intervention?

You give the 2nd shock to the patient and begin 5 cycles of CPR. What do you do next during CPR?

After the epinephrine is given, you should do what?

After CPR your rhythm check shows continued VF. You shock the patient a 3rd time with 300 J and begin another 5 cycles of CPR. What do you do now?

You give amiodarone 300 mg IV x 1 and finish the 3rd cycle of CPR.

(True or False): The maximum 24 hour cumulative dose for amiodarone is 2.2 mg/kg.

Keeping in mind that the maximum cumulative 24 hour dose for amiodarone is not weight based but is 2.2 grams you continue ACLS. You follow the first dose of amiodarone with 5 cycles of CPR then a rhythm check reveals no change. You shock again and start another round of CPR (5 cycles). You can repeat the amiodarone at this time. How much amiodarone do you give for the second dose?

You give a second dose of amiodarone IV, and your team has continued to administer epinephrine 1mg IV every 3-5 minutes. What should you do next?

You complete 5 cycles of CPR and perform a rhythm check. This is what you see on the monitor:

What is the rhythm?

You recognize the rhythm as asystole and promptly provide what medication?

You provide 5 cycles of CPR, perform a rhythm check (no change), and give another dose of epinephrine 1mg IV, followed by 5 cycles CPR. After the CPR this is what you see:

The patient does not have a pulse. What do you perform next?

You shock (defibrillate) at 360 J and then provide 5 cycles of CPR. Your rhythm check is as shown below:

What should you do at this time?

A pulse check is performed, and the patient has a pulse. Her vital signs are HR 85, occasional spontaneous respirations, BP 102/63. The patient is also having very frequent PVC's. What are two most important interventions at this time?

Congratulations for saving the patient. She is stable and being transported to the ICU. What would be the beginning slow infusion dose for the antiarrhythmic, amiodarone, infusion?