Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is a critical element in early resuscitation for a patient with shockable rhythms?

1. High-quality chest compressions

2. Administering antiarrhythmic drugs

3. Rapid intravenous access

4. Initiating aggressive fluid resuscitation

The correct answer is: High-quality chest compressions

High-quality chest compressions are a cornerstone of effective cardiopulmonary resuscitation (CPR) and a critical component in the early management of patients with shockable rhythms, such as ventricular fibrillation or pulseless ventricular tachycardia. The primary goal of chest compressions is to maintain coronary and cerebral perfusion, which is essential for the patient's survival and immediate neurological outcomes. During a cardiac arrest, the heart is unable to pump blood effectively, leading to a lack of oxygen to vital organs. High-quality chest compressions help to create artificial circulation by repeatedly compressing the chest, thereby forcing blood out of the heart and into the systemic circulation. It’s essential that these compressions are performed at an adequate rate (100-120 compressions per minute) and depth (about 2-2.4 inches) with minimal interruptions to maximize blood flow and maintain perfusion to the brain and heart. While administering antiarrhythmic drugs, establishing rapid intravenous access, and initiating aggressive fluid resuscitation are also important interventions in specific situations, they do not replace the immediate need for high-quality chest compressions during the critical first minutes of cardiac arrest. High-quality compressions set the foundation for all subsequent resuscitative efforts,