Advanced Cardiovascular Life Support (ACLS) Practice Exam

What should be performed if a patient is in a comatose state after resuscitation?

1. Initiate hypothermia protocol

2. Wait for the patient to awaken

3. Give intravenous fluids

4. Start chest compressions

The correct answer is: Initiate hypothermia protocol

If a patient is in a comatose state after resuscitation, initiating a hypothermia protocol is the recommended course of action. This is based on evidence that therapeutic hypothermia can improve neurological outcomes in patients who have achieved return of spontaneous circulation (ROSC) after cardiac arrest but remain unresponsive. Cooling the patient's body temperature slows down metabolic processes and can help reduce the risk of brain injury due to ischemia, thus enhancing the chances of recovery. The other options do not address the immediate needs of a comatose patient post-resuscitation effectively. Waiting for the patient to awaken is inappropriate, as active intervention is crucial in this state to facilitate recovery. Administering intravenous fluids may be necessary at times, but it is not the direct or primary treatment for managing post-resuscitation comatose states. Simply starting chest compressions would not be appropriate, as the patient has already been resuscitated and would not be in cardiac arrest; such actions would be unnecessary and potentially harmful. Therefore, initiating hypothermia is the most beneficial and evidence-based step to take in this scenario.