Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is the first treatment priority for a patient who achieves ROSC?

1. Administer medications

2. Optimizing ventilation and oxygenation

3. Begin cardiac rehabilitation

4. Transfer to ICU

The correct answer is: Optimizing ventilation and oxygenation

After a patient achieves Return of Spontaneous Circulation (ROSC), the immediate focus shifts to optimizing ventilation and oxygenation. This is crucial because, even after ROSC, the patient's body may still be in a state of oxygen debt due to the preceding cardiac arrest. Ensuring adequate ventilation and oxygenation helps to stabilize the patient, support brain recovery, and maintain organ function. In the post-ROSC phase, it's vital to monitor the patient’s respiratory status closely. Providing supplemental oxygen, ensuring proper airway management, and monitoring the EtCO2 levels are essential components of this care. Optimizing these parameters can prevent hypoxia and contribute to better outcomes in recovery. While other options such as administering medications, cardiac rehab, or transferring to the ICU are important steps in the post-resuscitation care pathway, they are secondary to ensuring the patient is adequately ventilated and oxygenated first. Without proper ventilation and oxygenation, the effectiveness of subsequent treatments may be compromised.