Sun31October0735PM 14
A 50-year-old male patient is brought to the emergency department having sustained a witnessed cardiac arrest. He has a history of coronary artery disease and diabetes.
On arrival he is intubated and having chest compressions performed by the paramedics. He has one "blue" cannula inserted in his right antecubital fossa. The paramedics hand over that he has had two cycles of the current ALS protocol. He is coming to the end of another cycle of advanced life support.
The team leader asks to stop chest compressions and the monitor is reviewed and the rhythm is consistent with VF. Meanwhile the defibrillator is being charged for a shock, according to the most up-to-date advanced life support guidelines.
What is the correct course of action?
(Please select 1 option)
Stop chest compressions
Perform a bedside echocardiogram
Continue chest compressions Correct
Leave the oxygen running to the patient
Try to secure an IV line
Explanation
The UK Resuscitation Council published updated clinical guidelines for adult advanced life support in 2010.
There are a number of changes to the guidelines. One of the most significant is the concentration on the importance of good chest compressions for as long as possible during resuscitation.
The new guidelines state that chest compressions should now continue while the defibrillator is being charged.
While this occurs, the oxygen supply to the patient should be removed.
Although the patient in this scenario is likely to need better intravenous access, the new guidelines state that only the team member performing chest compressions should be touching the patient while the defibrillator is charging, hence leaving the oxygen running to the patient and trying to secure an IV line are incorrect.
The new guidelines recognise the potential use of ultrasound during cardiopulmonary resuscitation; it should be performed at a different stage (for example, while the pulse is being checked).
Answer Statistics
1
1%
2
1%
3
97%
4
2%
5
1%
Times answered: 271