ACLS review

226.  What should the rescuer do as he/she is clearing the patient prior to delivering a shock?

The person operating the defibrillator should make a visual check to ensure that no one is touching the patient or stretcher. 

227.   Why is it necessary to use conductive gels when using defibrillator paddles?

Conductive materials are used to reduce transthoracic resistance (resistance to the electrical current).  Conductive materials include electrode gels or pastes or gel pads.  Also remember to maintain firm downward pressure of the paddles to ensure adequate skin to paddle contact.

228.  When treating a cardiac arrest patient, when should pulse checks be performed? 

Ideally pulse checks should be performed during the rhythm analysis.  If an organized rhythm is noted on the monitor during the rhythm analysis, then a team member should palpate the patient for a pulse.   This ideally should take no more than 10 seconds.  If there is any doubt about the presence of a pulse, then resume CPR

229.  Immediately after the first shock an organized rhythm is noted on the monitor.   A team member palpates the patient for a pulse but does not detect a pulse.   What would be the next appropriate intervention?

Begin CPR beginning with chest compressions and treat the patient according to the PEA algorithm. 

230.  What vasopressor is recommended in the treatment of pulseless VF/VT?

Epinephrine 1mg IV/IO- may repeat every 3-5 minutes


Reviewed 2/28/16