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Use this scenario to answer questions 16-17:An unresponsive 14-year-old girl is pale and cool to the touch. Her blood pressure is 70/45 mm Hg, heart rate is 190/min, and respiratory rate is 12/min. The SpO2 is not detectable. Capillary refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. If pharmacological interventions are unavailable or delayed, what intervention is indicated?

Use this scenario to answer questions 6-7: An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and SpO2 is 60% on room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. What action do you take next?

Use this scenario to answer questions 16-17:An unresponsive 14-year-old girl is pale and cool to the touch. Her blood pressure is 70/45 mm Hg, heart rate is 190/min, and respiratory rate is 12/min. The SpO2 is not detectable. Capillary refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. What rhythm is seen on the patient’s cardiac monitor?

Use this scenario to answer questions 36-37:You are caring for a 5-year-old boy with a 4-day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His oxygen saturation is 72% on room air and 89% when on a nonrebreathing oxygen mask. He has shallow respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles. What assessment finding is consistent with respiratory failure in this child?  

You are performing the Airway component of the primary assessment. What finding would lead you to conclude that a child has an upper airway obstruction?

For patients with ST-segment elevation myocardial infarction, which best describes the recommended maximum goal for first medical contact–to–balloon inflation time for percutaneous coronary intervention?

Use this scenario to answer questions 34-39: A 51-year-old patient is reporting stomach pain and chest discomfort that is radiating down their left arm. The patient had coronary artery stents placed 5 days ago. The patient’s skin is pale and cool to the touch. Their blood pressure is 72/46 mm Hg, mean arterial pressure is 55 mm Hg, heart rate is 188/min, respiratory rate is 28 breaths per minute, and SpO2 is 89% on room air. The ECG shows ventricular tachycardia. While you administer supplemental oxygen, the patient suddenly loses consciousness, and the ECG monitor shows ventricular fibrillation. The patient has been intubated and shortly after gains return of spontaneous circulation but is not able to follow commands. Their vitals show heart rate of 110/min, mean arterial pressure of 70 mm Hg, respiratory rate of 6 breaths per minute, and oxygen saturation of 93% on 100% oxygen. A 12-lead ECG reveals ST-segment elevation in leads V2 through V4. While awaiting transfer to the cath lab for percutaneous coronary intervention, which post–cardiac arrest care intervention do you choose next for this patient?

A responder is caring for a patient with a history of heart failure. The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg (mean arterial pressure of 56 mm Hg), and a heart rate of 190/min. The patient’s lead II ECG is displayed here. Which best characterizes this patient’s rhythm?

Use this scenario to answer questions 30-33: A 62-year-old patient reports having light-headedness, nausea, and chest discomfort. The patient is awake and responsive but appears ill, pale, and grossly diaphoretic. There is no obvious dependent edema, and their neck veins are flat. Their lung sounds are equal with moderate bilateral fine crackles. You are unable to hear a blood pressure. Their radial pulse is weak, thready, and fast. The cardiac monitor shows the rhythm seen here. Which ACLS algorithm should you follow?

During a resuscitation attempt, Rescuer 1 is performing chest compressions while Rescuer 2 is managing the airway. The CPR Coach notes that the PETCO2 reading is 18 mm Hg. At the 2-minute mark, Rescuer 1 and Rescuer 2 switch positions. After the CPR Coach directs the team to resume CPR, the Coach notes that the PETCO2 reading is 9 mm Hg. What action should the CPR Coach take next?