Level 6 - Advanced Resuscitation Revision

Magnesium sulfate is the drug of choice for use in Torsades de Pointes, a type of irregular heart rhythm. This condition is often caused by a prolonged QT interval, which can be corrected by administering magnesium. Magnesium sulfate helps to stabilize the electrical activity of the heart and prevent further episodes of Torsades de Pointes. It is considered the most effective and reliable treatment for this condition.

Asystole is the correct answer because it is the most common rhythm for children in cardiac arrest. Asystole refers to the absence of any electrical activity in the heart, resulting in a flatline on the electrocardiogram (ECG). In this state, the heart is not contracting or pumping blood effectively, leading to a life-threatening condition. Prompt medical intervention, such as cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS), is crucial to restore a normal rhythm and improve the chances of survival.

CPR on babies should be done just below the nipple line because the correct hand placement for chest compressions is on the lower half of the sternum, which is located just below the nipple line. This ensures that the compressions are effective and target the heart, which is located in the center of the chest. Placing the hands directly on or just above the nipple line would not provide the necessary pressure to properly perform CPR on a baby.

A pre-cordial thump is a procedure used in emergency medicine to treat certain life-threatening heart rhythms. It involves delivering a strong blow to the chest in an attempt to restore a normal heart rhythm. However, studies have shown that this technique is only effective in approximately 2% of cases. Therefore, the correct answer is 2%.

If bystanders begin CPR immediately in a community arrest, the chances of survival increase 3-fold. This means that the survival rate is three times higher compared to situations where bystanders do not perform CPR right away. Immediate CPR can help maintain blood flow and oxygenation to vital organs until professional medical help arrives, increasing the likelihood of survival.

Colloids should be used for resuscitation during anaphylaxis. Colloids are a type of fluid that contain larger molecules, such as proteins or starches, which help to increase the volume of blood plasma. This can be beneficial during anaphylaxis as it helps to maintain blood pressure and prevent further complications. Normal saline and glucose are not typically used for resuscitation during anaphylaxis as they do not provide the same volume-expanding effects as colloids.

Expired air ventilation refers to the process of exhaling air from the lungs. The oxygen concentration in expired air is lower than in inhaled air due to the exchange of oxygen and carbon dioxide that occurs during respiration. While the exact percentage of oxygen in expired air can vary depending on factors such as metabolism and lung health, on average, it is around 16%.

Mouth-to-mask ventilation is more effective than bag-to-mask because it allows for a better seal between the mask and the patient's face, ensuring that the delivered air goes directly into the patient's lungs. In bag-to-mask ventilation, there is a higher risk of air leakage as it requires the provider to hold the mask against the patient's face, potentially leading to inadequate ventilation. Additionally, mouth-to-mask ventilation allows for a more controlled and consistent delivery of breaths, resulting in better oxygenation and ventilation.

An unconscious adult diabetic should be given Glucose 10% 100mls because this solution provides a higher concentration of glucose, which is necessary to quickly raise blood sugar levels in a diabetic patient. The higher concentration of glucose in the solution ensures that enough glucose is absorbed into the bloodstream to counteract hypoglycemia effectively. Giving a lower concentration or a smaller volume may not provide enough glucose to adequately treat the low blood sugar levels in the unconscious patient.