Apatient experiences cardiac arrest, and the resuscitation team initiates ventilations using a bag-valve-mask (BVM) resuscitator. The development of which condition during the provision of care would lead the team to suspect that improper BVM technique is being used?
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ACLS Final Exam
Apatient experiences cardiac arrest, and the resuscitation team initiates ventilations
using a bag-valve-mask (BVM) resuscitator. The development of which condition during
the provision of care would lead the team to suspect that improper BVM technique is
being used?
Complications can occur with the use of a BVM resuscitator due to improper technique.
Delivering excessive volume or ventilating too fast creates excessive pressure that can
damage the airways, lungs and other organs. Excessive volume can lead to tension
pneumothorax.
A person suddenly collapses while sitting in the sunroom of a healthcare facility. A
healthcare provider observes the event and hurries over to assess the situation. The
healthcare provider performs which assessment first?
Rapid assessment
Basic life support assessment
Secondary assessment
Primary assessment - Answer - Rapid assessment
A systematic approach to assessment is necessary. The healthcare provider should first
perform a rapid assessment. A rapid assessment is a visual survey to ensure safety,
form an initial impression about the patient's condition (including looking for life-
threatening bleeding), and determine the need for additional resources. This would be
followed by a primary assessment and then a secondary assessment.
A patient is receiving ventilation support via bag-valve-mask (BVM) resuscitator.
Capnography is established and a blood gas is obtained to evaluate the adequacy of
the ventilations. Which arterial carbon dioxide (PaCO2) value signifies adequate
ventilations?
10 to 15 mmHg
20 to 25 mmHg
25 to 30 mmHg
35 to 45 mmHg - Answer - 35 to 45 mmHg
Arterial carbon dioxide (PaCO2) values in the range of 35 to 45 mmHg confirm
adequacy of ventilation.
,A resuscitation team is debriefing following a recent event. A patient experienced
cardiac arrest, and advanced life support was initiated. The patient required the
placement of an advanced airway to maintain airway patency. Which statement
indicates that the team performed high-quality CPR?
"We initiated chest compressions at a rate of 100 to 110 per minute to a depth of 2.4
inches and then gave 1 ventilation every 10 seconds."
"We provided chest compressions at a rate of 100 to 120 compressions per minute
while giving 1 ventilation every 6 seconds without pausing compressions."
"We provided chest compressions at a rate of 80 to 120 per minute to a depth of at least
2 inches and gave 1 ventilation every 6 seconds without pausing compressions."
"We kept the rate of chest compressions to around 100 per minute but adjusted their
depth to 1.5 inches while giving 1 ventilation every 3 seconds without pausing
compressions." - Answer - "We provided chest compressions at a rate of 100 to 120
compressions per minute while giving 1 ventilation every 6 seconds without pausing
compressions."
When an advanced airway has been placed in a patient who is in cardiac arrest,
compressions should be delivered continuously (100 to 120 per minute) with no pauses
for ventilations.
Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen
saturation (SaO2) level of 88%. The provider would interpret these findings as indicative
of which condition?
An SaO2 level of less than 90% (PaO2 of less than 50 mmHg) accompanied by ETCO2
values greater than 50 mmHg is indicative of respiratory failure.
A responsive patient is choking. What method should the provider use first to clear the
obstructed airway?
Back blows
Abdominal thrusts
Magill forceps extraction
Chest compressions - Answer - Back blows
To clear an obstructed airway in a responsive adult, first provide up to 5 back blows to
clear the obstruction.
A patient arrives at the emergency department complaining of shortness of breath. The
patient has a long history of chronic obstructive pulmonary disease. Assessment
, reveals respiratory failure. Which action would be the initial priority to address the
respiratory failure?
Establishment of vascular access
Delivery of supplemental oxygen via nasal cannula
Assisted ventilation with BVM resuscitator
Initiation of capnography - Answer - Assisted ventilation with BVM resuscitator
Patients who cannot ventilate adequately despite an open airway or who have
insufficient respiratory effort require assisted ventilation initially provided via a BVM
resuscitator.
A 20-year-old man with respiratory depression is brought to the emergency department
by his parents. Opioid overdose is suspected, and an initial dose of naloxone is
administered at 10 p.m. The patient does not respond to this initial dose. The team
would expect to administer a second dose after how many minutes?
The dose of naloxone may be repeated after 2 to 3 minutes.
Assessment of a patient in the emergency department reveals that the patient is
experiencing respiratory compromise. From the assessment, the team identifies that the
patient is in the earliest stage of this condition. Which stage would this be?
Respiratory compromise occurs along a continuum, beginning with respiratory distress,
progressing to respiratory failure and then to respiratory arrest.
The following capnogram is from a patient experiencing respiratory distress. At which
point in the waveform would the patient's ETCO2 level be measured?
B
C
D
E - Answer - D
The ETCO2 value is measured at the end of exhalation (point D), which represents the
peak level.
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