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02 S P M P On Cardiovascualar Collapse

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02 S P M P On Cardiovascualar Collapse

  1. 1. SPMP Sudden Cardiovascular Collapse<br />Dr. S. Aswini Kumar. MD,<br />This is the most important medicaI emergency that can happen under any circumstance<br />II. 01. A patient with Acute MI abruptly develops absent radial pulse, you will now suspect:<br />Cardiogenic shock<br />Acute LVF<br />Acute Pulmonary embolism<br />Intra Cerebral Hemorrhage<br />Cardiac Arrest<br />II. 02. You will now proceed to do the following physical examinations EXCEPT:<br />Palpation of carotid pulse<br />Measurement of BP<br />Checking the pupillary reflexes<br />Auscultating for heart sounds<br />Checking responsiveness<br />II. 03. You will now order the following emergency investigations immediately: <br />Random Blood Sugar<br />Serum electrolytes<br />12 lead ECG<br />Chest X ray PA view<br />None of the above<br />II. 04. The cardiac monitor is likely to show one of the following cardiac rhythms EXCEPT:<br />Ventricular fibrillation<br />Pulseless Ventricular tachycardia<br />Cardiac asystole<br />Atrial fibrillation<br />Pulseless Electrical Activity<br />II. 05. External chest cardiac massage should be started immediately because:<br />Other wise patient will go into Acute LVF<br />Patient will develop cardiogenic shock<br />Brain cannot sustain life without O2 for >4 minutes<br />To show relatives that something is being done<br />Defibrillation can be postponed<br />II. 06. Ideal rate of doing External Chest Cardiac massage is:<br />40-60/min<br />70-80/min<br />120/min<br />Alternating with artificial ventilation<br />Once in 3 minutes<br />II. 07. Following steps in performance of ECCM are correct EXCEPT:<br />Hands are placed over lower sternum,<br />4 cm deep compressions are given <br />The elbows are kept at an angle of 1300 <br />The pressure is applied from the shoulder <br />30 cardiac compressions 2 assisted breaths <br />II. 08. If the ECG monitor shows Ventricular fibrillation, you will give: <br />Synchronized DC shock of 100 joules <br />Synchronized DC shock of 300 joules <br />Non-synchronized DC shock of 100 joules<br />Non-synchronized DC shock of 200 joules<br />Continue ECCM without giving DC shock<br />II. 09. All are TRUE about technique of giving defibrillation EXCEPT:<br />One paddle along right anterior axillary line<br />Other paddle lateral to left anterior axillary line<br />Conductive gel applied on it reduces impedance<br />None including the one giving shock shall touch the cot<br />Paddle buttons are pressed one after the other<br />II. 10. In case of persistent VT or VF following may be considered EXCEPT:<br />Injection Adrenaline 1mg IV q3-5min<br />Inj. Vasopressin 40 units IV single dose <br />Resume attempts to defibrillate with 300 or 360 joules<br />Anti-arrhythmics like amiodarone <br />Discontinue ECCM at this stage of cardiac resuscitation<br />II. 11. All are TRUE regarding Intra-cardiac Adrenaline EXCEPT:<br />Not routinely recommended <br />Cardiac asystole is the only indication <br />Given in 3rd left IC space 4 cm lateral LSB<br />Increases myocardial & cerebral blood flow<br />Repeated for 3 or 4 doses; not more<br />II. 12. Techniques for establishing an airway are the following EXCEPT:<br />Assess breathing first; then ensure open airway<br />Insert an oropharyngeal airway <br />Consider foreign body and remove it<br />Do Endo-tracheal intubation quickly<br />The concentration of oxygen given should be 80%<br />II. 13. All of the following are shockable rhythms EXCEPT:<br />Coarse ventricular Fibrillation<br />Fine ventricular Fibrillation<br />Pulseless Ventricular Tachycardia <br />Supraventricular Tachycardia<br />Cardiac Asystole<br />II. 14. All of the following will confirm Cardiac asystole EXCEPT:<br />Monitor shows a flat line<br />This is verified in another lead<br />The monitor power is on <br />The lead connections are intact<br />The monitor gain is down<br />II. 15. All are TRUE about the administration of sodium bicarbonate EXCEPT:<br />Not recommended for routine use<br />Use based on clearly defined diagnosis<br />Hyperkalemia is the indication<br />Can be used in pre-existing alkalosis<br />Dose is 1meq/kg intravenously<br />II. 16. The maximum time allowed to interrupt CPR is:<br />10 seconds<br />30 seconds<br />60 seconds<br />120 seconds<br />180 seconds<br />II. 17. Decision to terminate Advanced Cardiac Life Support depends on all EXCEPT:<br />Individual situations<br />Pre-arrest conditions<br />Intra-arrest conditions<br />Response to resuscitation<br />Patient’s wishes<br />

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