Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is an important intervention for a patient who achieves ROSC during out-of-hospital resuscitation?

1. Administer high-flow oxygen immediately

2. Transport the patient to a facility capable of performing PCI

3. Perform additional CPR for 5 minutes

4. Initiate therapeutic hypothermia on site

The correct answer is: Transport the patient to a facility capable of performing PCI

Transporting the patient to a facility capable of performing percutaneous coronary intervention (PCI) is a critical intervention for someone who has achieved return of spontaneous circulation (ROSC) during out-of-hospital resuscitation. This choice is grounded in the understanding that patients who experience cardiac arrest due to a suspected cardiac cause benefit significantly from rapid access to advanced cardiac care. Once ROSC is achieved, there is a heightened risk of myocardial ischemia due to potential underlying coronary artery disease. The window for effective intervention is short; therefore, it is essential to transport the patient to a facility equipped to evaluate and treat possible coronary artery obstructions promptly. PCI is a key treatment to restore coronary blood flow, improving the chances of survival and reducing the likelihood of subsequent cardiac events. The other options, while they may hold some merit in specific contexts, do not prioritize the urgent need for specialized cardiac intervention. Administering high-flow oxygen without addressing the underlying cause of the cardiac arrest does not directly impact the patient's long-term outcomes. Performing additional CPR after ROSC has been achieved is unnecessary and could be counterproductive, as the focus should shift to monitoring and stabilization. Initiating therapeutic hypothermia is beneficial but typically occurs in a controlled hospital environment rather than at the