ALS Scenario
You’re a Paramedic working with a Technician on a dual crewed Ambulance. You’re in the second half of the night shift and have just finished your first meal break. You’ve been asked to standby at a cover point. On the way, you’re allocated a cat 1 call for a 52-year-old cardiac arrest. The call is 2-minutes around the corner. Control inform you that back up is on the way, but will be around 15 minutes.
You arrive on scene and are ushered into the house by a concerned relative. She shows you up to the bedroom, where the patient is laying on the floor. The wife explains her husband started having a seizure in bed. She called 999, but then he stopped breathing. They told her to drag him on the floor and start CPR, but then you showed up.
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Question 1 of 10
1. Question
You reach down and assess the patient. There’s no breathing and no pulse. You confirm cardiac arrest to your colleague and they place the defibrillator pads on while you start chest compressions. On the manual defibrillator screen you see this rhythm:
What are your actions?
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Question 2 of 10
2. Question
You charge up the defibrillator and safely administer a shock to the patient. Your colleague has quickly managed to get some kit out and now takes over the chest compressions. You are currently working in the shockable cardiac arrest algorithm. At what point will you consider cardiac arrest drug administration?
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Question 3 of 10
3. Question
As you have 2 more cycles before administering cardiac arrest drugs, you assess the airway and manage ventilations. You look into the airway and can see significant secretions have collected. You apply suction and clear what you see. You decide to advance the airway to an SGA. With an SGA in place, at what rate can you ventilate the patient?
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Question 4 of 10
4. Question
As the SGA is classed as a secure airway, you are able to conduct continuous ventilations. You auscultate the patients’ chest and attach capnography which comes back as a reading of 2.8 mmHg. You’re happy that the SGA has formed a patent airway and it is now time for your next rhythm check. The following shows with no pulse palpable:
What are your next actions?
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Question 5 of 10
5. Question
You note the change of rhythm to a PEA and look to gain IV access. You quickly manage to cannulate the patient. What cardiac arrest drug do you administer at this stage where no contra-indications are present?
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Question 6 of 10
6. Question
What is the dosage of the Adrenaline 1:10000?
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Question 7 of 10
7. Question
You administer the Adrenaline 1:10000 making a note of the time. You come to the end of the 2nd cycle and assess the rhythm. The following shows on the screen:
What are your actions?
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Question 8 of 10
8. Question
You note the pulseless VT and shock the patient. You continue to cycle with your colleague while managing the reversible causes where able. You come to the end of the 3rd cycle and are posed with the following rhythm with no pulse:
What are your actions?
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Question 9 of 10
9. Question
What are the time intervals between Adrenaline 1:10000 boluses?
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Question 10 of 10
10. Question
Your back up walks through the door. What correct information do you handover?
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