The best answer is: 1 and 2 only

The most common cause of treatable PEA is the development of a tension pneumothorax. In order for the lung to collapse and adequate pressure develop which suddenly tamponades blood vessels closed, requires positive airway pressure. Patients receiving positive airway pressure should be monitored carefully and if a tension pneumothorax develops, immediate decompression of the affected side of the chest will reverse the problem. No patient should die of an untreated tension pneumothorax in a critical care or anesthesia setting.

The best answer is: defibrillation

When ventricular fibrillation occurs in the monitored patient, no time should be wasted on anything other than terminating the arrhythmia. Immediate defibrillation is required. When initial attempts at defibrillation fail, quality CPR should be administered while advanced airway management occurs and drugs are administered. Lidocaine does not enhance the ability to treat refractory ventricular fibrillation, however, it may be helpful in preventing ischemic re-induction. The routine use of lidocaine in treating refractory VF has poor scientific evidence to support its use although commonly used.  

The best answer is: fibrinolytic agents

Alteplase, recombinant (rtPA); rtreptokinase; reteplase recombinant and tenecteplase are all fibrinolytic agents

The best answer is: all of the above

According to the most recent Guidelines, the following are relative exclusion criteria:

• Symptoms that seem minor and are clearing rapidly
• Onset of symptoms accompanied by seizure with residual impairment
• Significant trauma or surgery in the previous 14 days
• GI or GU hemorrhage with the last 21 days
• Acute MI within 3 months

The above need to be considered by carefully weighing the risk vs. the benefit when deciding to employ fibrinolytic therapy.

The best answer is: no

Atropine may benefit patients with transient issues that alter sinus node function or AV node conduction. Based on the end-stage appearance of the patient in this case study, no therapy would improve his outcome or long-term survival.