ADVANCED LIFE SUPPORT

ANSWERS IN ITALICS WITH REFERENCES

1. The guidelines suggest that in out-of-hospital cardiac arrests, attended but
unwitnessed by health care professionals equipped with a manual defibrillator,
the providers should;
(a) not delay defibrillation
(b) give 2 minutes of CPR before defibrillation
(c) monitor firstly with defibrillation electrodes and then do CPR
(d) Do chest compressions until the defibrillator is attached and then shock
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 41 Paragraph 2 ALS /GEN / DIF

2. The guidelines suggest that in out-of-hospital cardiac arrest events where the
arrest is witnessed by health care professional with a manual defibrillator, the
providers should;
(a) administer 2 minutes of compressions before a single shock is delivered
(b) use a 3 quick shocks in succession policy
(c) secure the airway and then do 2 minutes of chest compressions
(d) administer a single shock straight away
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 41 Paragraph 2 ALS /GEN / DIF

3. In ALS the guidelines suggest that where VF/VT persists, adrenaline should
be given;
(a) after the second shock
(b) as soon as venous access is obtained
(c) after the first shock
(d) only after 3 unsuccessful shocks
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 41 Paragraph 5 ALS /DRG / ADR

4. In ALS the guidelines suggest that where VF/VT persists, adrenaline should
be repeated;
(a) every 3 – 5 minutes
(b) every loop after the first adrenaline has been given
(c) before every shock
(d) to coarsen up the rhythm and make it more receptive to shocking
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 41 Paragraph 5 ALS / DRG / ADR

5. Amiodarone is given as a bolus dose of;

(a) 300 mg IV
(b) 100 mg IV
(c) 1 mg in 10mls
(d) 300 micrograms in 10 mls
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 43 Paragraph 2 ALS / PRC / DRG / AMI

6. Following a DC shock the rescuer should;

(a) Check for spontaneous rhythms returning
(b) check for a pulse
(c) immediately resume chest compressions without assessing the rhythm or pulse
(d) check for both pulse and rhythm changes
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 43 Paragraph 5 ALS / DIF

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ADVANCED LIFE SUPPORT

7. A precordial thump can be used following a collapse where;

(a) it is witnessed and monitored and a defibrillator is not immediately available
(b) it is witnessed by sight or sound
(c) it is assumed to be caused by VF or VT
(d) the event is likely to be caused by asystole only
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 44 Paragraph 2 ALS / THU

8. A precordial thump, when used, should be delivered to the;

(a) mid sternum
(b) lower sternum from a height of 20 cm
(c) apex of the heart
(d) middle of the chest at a height of 4 inches (20 cm).
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 44 Paragraph 2 ALS / THU

9. A precordial thump is most likely to convert;

(a) VF to asystole
(b) VF to sinus rhythm
(c) asystole to a perfusing rhythm
(d) VT to sinus rhythm
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 44 Paragraph 2 ALS / THU

10. A precordial thump is most likely to successfully convert VF if delivered

within the first
(a) 10 seconds
(b) 20 seconds
(c) 30 seconds
(d) 4-5 minutes
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 44 Paragraph 2 ALS / THU

11. Modern biphasic defibrillators should successfully terminate VF (shock

efficacy) in;
(a) 65% of cases
(b) 75% of cases
(c) 80% of cases
(d) 90% of cases
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 45 Paragraph 2 ALS / DIF

12. Post shock compressions;

(a) may convert asystole to VF
(b) may increase the chances of new VF following a perfusing rhythm
(c) can increase the chances of VF converting spontaneously
(d) should be done less aggressively so as not to cause new VF
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 45 Paragraph 2 ALS / PRC / COM

13. Following an unsuccessful shock evidence shows that subsequent shocks;

(a) at fixed energy levels is better
(b) at escalating energy levels is better
(c) are unlikely to convert VF without additional drugs
(d) at escalating levels are not likely to be better than fixed levels
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 45 Paragraph 3 ALS / DIF / PRC
ADVANCED LIFE SUPPORT

14. In ALS the 2005 guidelines suggest monophasic defibrillators should be used
at;
(a) an energy of 360 J
(b) an energy of 150-200J
(c) escalating energies starting at 150J
(d) the lowest possible energy because of potential myocardial damage
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 45 Paragraph 4 ALS / DIF

15. If the victim’s rhythm is found to be fine ventricular fibrillation;

(a) the treatment will be no different if it were coarse VF
(b) you must confirm that the leads have a good connection
(c) then do not attempt defibrillation
(d) then change the position of the electrodes
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 1 ALS / VF

16. Evidence that adrenaline can increase survival to hospital discharge;

(a) is very clear
(b) is not very clear
(c) is very poor
(d) does not exist
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 2 ALS / DRG / ADR / PRC

17. Adrenaline should be given between the last compression and the shock;
(a) so that it can be circulated by the CPR following the shock
(b) to increase the chances of effective shock
(c) to decrease the pro-arrhythmic effect of the drug
(d) to increase the coronary perfusion pressure following a successful shock
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 3 ALS / DRG / ADR

18. In ALS the guidelines say check the rhythm;

(a) following each shock
(b) at 1 minute after a shock
(c) at 2 minutes after a shock
(d) only if normal breathing returns
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 4 ALS / GEN

19. You should check for a pulse following a shock

(a) only if you see any rhythm on the monitor
(b) at the appropriate time only if a non-shockable organised rhythm is present
(c) immediately but for no more than 10 seconds
(d) straight away so as to avoid during compressions over spontaneous rhythms
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 4 ALS / PRC / DIF / GEN

20. If you should see an organised rhythm during the post shock compressions;
(a) stop compressions immediately
(b) do not interrupt chest compressions unless the patient shows signs of life
(c) continue compressions regardless
(d) avoid during further compressions until a pulse check is done
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 4 ALS / PRC / GEN / DIF / COM
ADVANCED LIFE SUPPORT

21. If there is doubt about the presence of a pulse in a patient who regains an
organised rhythm;
(a) ask a colleague to try
(b) relocate your finger position over the artery
(c) resume CPR
(d) palpate another major artery
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 4 ALS / PRC / GEN

22. In the 2005 guidelines, give adrenaline for;

(a) asystole only
(b) asystole and PEA only
(c) asystole, PEA, VF and pulseless VT
(d) asystole, PEA, VF only
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 4 ALS /DRG / ADR

23. The ALS guidelines suggest that adrenaline is given for asystole or PEA;
(a) after 2 sequences of 30:2
(b) only after the airway is secured
(c) every 2 minutes
(d) as soon as IV access is achieved
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 5 ALS / DRG / ADR / ASY / PEA

24. When the rhythm is asystole or PEA, adrenaline should be given;

(a) every 3-5 minutes (approximately every other 2 minute loop).
(b) before every 2 minute loop
(c) after every 2 minute loop
(d) at any time during each 2 minute loop
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 46 Paragraph 6 ALS / ASY / PEA / ADR / DRG

25. When compared to placebo and lignocaine, amiodarone given for shock
refractory VF/VT;
(a) has been shown to improve both survival to hospital and hospital discharge
(b) has been shown to improve survival to hospital
(c) has yet to show any improvement
(d) has been shown to improve survival to hospital discharge
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 47 Paragraph 2 ALS / PRC / DRG / AMI

26. In the 2005 guidelines amiodarone should be given;

(a) before delivery of the fourth shock
(b) after 5 unsuccessful shocks
(c) after lidocaine has been tried but appears to be ineffective
(d) only as a last resort
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 47 Paragraph 2 ALS / DRG / AMI

27. In PEA give adrenaline 1mg IV

(a) as soon as IV access is achieved
(b) only when the rate is less than 60/min
(c) under no circumstances
(d) after the atropine
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 47 Paragraph 4 ALS / PRC / DRG / ADR / PEA
ADVANCED LIFE SUPPORT

28. Under the 2005 guidelines, in cardiac arrest where there is an unsecured
airway;
(a) do continuous compressions
(b) ventilate once every 6 seconds
(c) continue CPR at 30:2
(d) attempt endotracheal intubation as soon as possible
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 47 Paragraph 4 ALS / GEN / PEA

29. Atropine can be used

(a) for asystole and VF
(b) for asystole and PEA when the rate is <60 min
(c) only for PEA when the rate is <60 min only
(d) for asystole only
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 48 Paragraph 3 ALS / PRC / DRG / ATR

30. Potentially reversible causes. - the 4 H’s stand for;

(a) hypothermia, hypoxia, hyperkalaemia and hyperlipidaemia
(b) hypokalaemia, hypocalcaemia, hypothermia and hypertension
(c) hypoxia, hypovolaemia, hyperkalaemia and hypothermia
(d) hyperkalaemia, hypokalaemia, hypocalcaemia and hypercalcaemia
Resuscitation Guidelines 2005 Resuscitation Council (UK) Page 49 Paragraph 1 ALS / PRC /