Exam (elaborations)
Sharp ESO 2024 Questions and Answers 2024
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Exam of 16 pages for the course SHARP at SHARP (Sharp ESO 2024)
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Sharp ESO 2024Nurse initiating ESO will document - answer1. Life threatening condition
2. Precipitating factors
3. Specific ESO implemented
4. Patient response
5. When and which physician was notified
ESO are initiated: - answer For life-threatening patient conditions in the absence of the
physician or specific orders
Adequate CPR - answer1. Push hard
2. Full chest recoil
3. Minimize interruptions
4. 100-120 compressions/min
5. 15 L O2 by bag mask (10 breaths per min)
6. 30:2
ETCO2 monitoring - answer Use to assess quality of CPR and evaluate return of rosc
How many breaths with advanced airway? - answer1 breath every 6 seconds
Targeted temperature management - answerShould be used on all patients not
following commands or purposeful movement within 120 mins after ROSC
What is a rapid bolus? - answerFluids administered in 5-15 mins
Non invasive cardiac monitoring - answerDevice that uses bioreactane to determine
cardiac output and is implemented where available by RRT or ICU RN to determine fluid
responsiveness and guide fluid resuscitation
Passive leg raise - answerPosition patient flat on their back, and their legs are elevated
to 45 degrees.
These interventions are instituted for all emergency situations outlined in the ESO
Standardized Procedure: - answer1.
Obtain intravenous (IV)/intraosseous (IO) access
2. Begin IV infusion of normal saline (NS) at keep vein open (KVO). If IV access is
unavailable: Lidocaine, Epinephrine, Atropine, and Naloxone (Narcan) may be
administered via endotracheal route at doses of 2-2 1/2 times the IV dose.
,3. If IV access is unavailable, Naloxone (Narcan) may be administered IM at the same
dose as IV administration
4. Flush the IV line with 20mL of NS after each IV medication given and elevate the
extremity if applicable.
5. In applicable situations, obtain oxygen (O2) saturation
6.Monitor and document ETCO2 for code blue events.
7. Titrate oxygen to patients' response.
Signs (objective): - answerTachypnea, apnea, respiratory depression, tachycardia,
bradycardia, arrhythmias, hypotension, decreased O2 saturation, dyspnea, change in
level of consciousness, increased intracranial pressure (ICP), status epilepticus
Symptoms (subjective) - answerDizziness, lightheadedness, chest pain, shortness of
breath (SOB), chest pain, weakness, cold, diaphoresis, heart palpitations, anxiousness
What is the initial treatment for asystole? - answerInitiate CPR immediately
What is the recommended oxygen flow rate for a patient in asystole? - answerO2 at
15L/minute ambu bag (10 breaths/minute)
What medication is administered in asystole and how often? - answerEpinephrine 1mg
IVP/IO (0.1 mg/mL), repeat every 3-5 min
How frequently should pulse checks be performed during CPR for asystole? -
answerEvery 2 minutes
What should be verified before initiating treatment for asystole? - answerVerify with
pulse check and ensure that all leads are connected
Bradycardia - Initial Treatment - answer1. O2 at minimum 10 L/minute (NRBM)
Bradycardia - Atropine Administration - answer1. Atropine 1mg IVP/IO, repeat every 3-5
minutes up to a maximum of 3 mg
Bradycardia - Dopamine Administration - answer1. Start Dopamine 400mg/250 mL
D5W at 5 mcg/kg/minute if above algorithm is ineffective. ICU or RRT RN to titrate until
patient is asymptomatic.
Bradycardia - Epinephrine Administration - answer1. Start Epinephrine 2mg/250 mL NS
at 2mcg/minute if above algorithm is ineffective. Titrate to patient response up to 10
mcg/minute. (RRT or ICU RN Only)
, What are common causes of Pulseless Electrical Activity (PEA)? - answerHypovolemia
and hypoxia
What is the recommended initial intervention for PEA? - answerCPR
What mnemonic is used to assess possible causes of PEA? - answerH's and T's:
Hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia, hypoglycemia,
hypothermia; Toxins, tamponade, thrombosis, trauma, tension pneumothorax
What is the recommended oxygen delivery method for PEA? - answerO2 at 15L/minute
via ambu bag (10 breaths/minute)
What medication is administered for PEA? - answerEpinephrine 1mg IVP/IO (0.1mg/ml),
repeat every 3-5 minutes
What is the next step if hypovolemia is known or suspected in PEA? - answerInfuse 250
mL NS rapid bolus. Repeat in 5 minutes if no clinical improvement. If lactated ringers
(LR) already infusing, may use LR
What imaging study is recommended for PEA? - answerStat chest x-ray (CXR)
What are the criteria for stable ventricular tachycardia? - answerPatient is conscious
with a systolic blood pressure (SBP) > 90 and does not have any unstable
signs/symptoms.
How should stable ventricular tachycardia be treated? - answer1. Call physician for
orders. 2. Administer oxygen at a minimum of 4L/min and titrate to patient response. 3.
Obtain a 12-lead ECG. 4. Draw serum potassium (K+) and magnesium (Mg++) levels.
What are the criteria for treating unstable ventricular tachycardia (VT)? - answerPatient
must be symptomatic, exhibiting one or more of the 'unstable' symptoms related to the
tachycardia.
How should unstable VT be treated? - answerThe patient should be immediately
cardioverted and treated with O2, synchronized cardioversion, medications like
Midazolam, 12 Lead EKG, and serum K+ and Mg++ levels should be checked.
What is the reversal agent for benzodiazepines in the context of treating unstable VT? -
answerFlumazenil (Romazicon) 0.2 mg IVP over 15 seconds.
What is Ventricular Fibrillation (VF)? - answerVF is characterized by disorganized
ventricular depolarization that is irregular and unable to generate any cardiac output. It
can be coarse or fine.
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