Case Study: Responding to a Holiday Emergency
Case studies are an excellent way to prepare for an upcoming ACLS certification exam. For the holidays, we’ve prepared a case study scenario that happens all too often during the festive season. Read the synopsis below, then check your answers to the follow-up questions.
SYNOPSIS
While attending an office holiday party, a 49-year-old male employee suddenly clutched his chest and collapsed to the ground. Fellow employees began quality CPR and a nearby wall-mounted automated external defibrillator (AED) was immediately accessed. The adhesive patches were placed on the victim’s chest, and the unit activated. All rescuers were warned to stop physical contact with the victim. A counter-shock was delivered and a second shock recommended. The unit delivered a second shock. The victim unexpectedly attempted to take a breath. His airway was opened and supported, and regular signs of spontaneous ventilation occurred. He was placed in the rescue position. 911 had been notified immediately after his collapse, and the paramedics arrived and took over his care. By the time he was loaded into the ambulance, he was verbalizing and regained good skin color. It was later learned that after arrival at the hospital, the man was diagnosed with an acute MI, and had been taken to the cardiac catheterization lab, in stable condition, for PCI.
QUESTIONS
1. Use of the AED is recommended for all adult sudden cardiac arrest events.
A. True
B. False
The best answer is A, True.
Here's Why: As with the victim in this case, for the majority of patients, ventricular fibrillation is the etiology of the arrest. Thus, defibrillation is the only useful method of treatment. Numerous studies have clearly shown that the faster electrical defibrillation occurs following arrest, the better the survival rate is.
2. In this case study, how important was CPR vs. immediate use of the AED?
A. CPR was more important than the immediate use of the AED
B. CPR was beneficial, but AED was the most effective initial treatment
The best answer is B, CPR was beneficial, but AED was the most effective initial treatment.
Here's Why: Although quality CPR has been shown to improve survival in cases where defibrillation is delayed, early defibrillation remains the single best initial treatment for the majority of patients developing sudden cardiac arrest.
3. If the AED was unsuccessful, which of the following statements is true:
1. A good patient outcome is dramatically reduced
2. Quality CPR should be continued
3. Secondary interventions such as I.V. medications are recommended
4. Medical futility may be present
A. 1 and 2 only
B. 3 and 4 only
C. All of the above
D. None of the above
The best answer is C, All of the above.
Here's Why: If the AED is unsuccessful, all four of the above statements are true.
4. Where are AEDs commonly placed in many communities?
A. Public buildings
B. In police vehicles
C. In sports clubs
D. In most commercial aircraft
E. All of the above
The best answer is E, All of the above.
Here's Why: Many public locations now have AEDs. Major department stores, shopping centers, malls, airports, community centers, and public transportation systems have installed them.
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