Question

1. For appropriate treatment, it is vital to discern if the QRS wave is ___________in a tachycardic individual.
   • Right or left
   • Positive or negative
   • Wide or narrow
   • Present or absent

2. After arrival of an acute stroke individual in the ED, in what time frame should an assessment and an order for a CT scan be completed?

1. • 30 minutes
   • 60 minutes
   • 10 minutes
   • 90 minutes

3. Which of the following is/are correct regarding individuals with acute stroke ?

1. • Hemorrhagic stroke is caused by the rupture of a blood vessel.
   • Ischemic stroke is caused by the occlusion of an artery.
   • Time between symptoms onset and time of arrival at an ED are critical to individual's survival.
   • All of the above

4. Which is/are possible underlying cause(s) of asystolic rhythms?

1. • Hypoxia
   • Pulmonary thrombosis
   • Hypovolemia
   • All of the above

5. Which of the following would be appropriate actions following transcutaneous pacing?

1. • Confirm ET tube placement with quantitative waveform capnography.
   • Administer amiodarone.
   • Follow VT/VF algorithm
   • Consult a specialist.

Answer 1

1. Tachycardia is the condition of rapid heartbeat usually more than 100 beats per minute. QRS wave of the electrocardiogram represents depolarization of the ventricles. QRS wave is of normally 120 milliseconds. In tachycardia individual, QRS wave can be wide or narrow. Wide QRS (>120msec.) occurs due to disturbed rhythmic wave of the heart muscles. Narrow QRS (<120msec) occurs due to rapid contraction of the ventricles (before normal activation time of contraction).

Answer: wide or narrow

2. For patients of acute stroke, CT scan order and interpretation should be done within 45 minutes of the arrival of the patient in the emergency department. Acute stroke is the condition of thrombosis or haemorrhage in the time frame of 24-hour of the incident.

Answer: 60 minutes

3. Acute stroke can be due blockage of blood vessels by clot (thrombosis) or due to embolic occlusion of the blood vessel. These factors result in ischemic stroke. While the rupture of the blood vessel leads to haemorrhagic stroke. Initial 24 hours are critical for the patients of acute stroke. So, immediate CT scan is essential for acute stroke patients in ED.

Answer : all of the above.

4. Asystolic rhythms is the condition in which there is no electrical conduction from the heart muscles or total failure of the electrical conduction. It can occur due to hypoxia (low oxygen supply to the heart muscles), hypovolemia (low blood supply to heart muscles), or pulmonary thrombosis (blockage of lung artery).

Answer: all of the above

5. Administering amiodarone is an appropriate action in this case.

Answer 2

Present or absent