ALS 3 Assessment

Because the best ALS therapies for the shockable and non-shockable rhythms differ and the ECG is highly susceptible to motion artifact, if the team does not agree on the rhythm diagnosis during the pause in chest compressions at the end of a BLS cycle, resumption of chest compressions should be delayed until all members of the team examine the ECG and agree upon a rhythm diagnosis.

Both pulseless VT and PEA are associated with consistent, repeated complexes on the ECG but no palpable pulses. Pulselss VT will more reliably be associated with which of the following?

A 9 year old Doberman Pinscher presents to your clinic for weakness, cough and lethargy. He is non-ambulatory, and was carried into the treatment area. You connect an ECG and see wide complexes at a rate of 242 per minute although his pulse rate is only 96 per minute. How would you treat this dog?

At the end of a cycle of BLS, you evaluate the ECG and diagnose ventricular fibrillation. You continue chest compressions while charging the defibrillator and then pause compressions to administer the shock. What is the correct next step?

Although biphasic electrical defibrillators are more efficacious for treating VF and pulseless VT than monophasic defibrillators, the same dosing chart may be used for both types.

A patient has been in pulseless VT for 5 cycles of CPR, meeting the criteria for prolonged pulseless VT. You have been treating with good quality BLS and electrical defibrillation per the RECOVER guidelines. Which of the following would be a useful additional therapy in this patient?

The goal of defibrillation is to reset the pacemakers in the SA node and establish a perfusing rhythm, so it may be useful in patients with prolonged asystole.

All of the following are important aspects of electrical defibrillator safety EXCEPT:

When performing a precordial thump on a cat, it is important to strike the chest directly over the heart with as much force as possible to stun as many ventricular myocardial cells as possible.

Low-dose epinephrine should be administered every other cycle of CPR in all patients with shockable arrest rhythms.