ACLS Provider Course Testing Scenario 3: Unstable Bradycardia → VF → Asystole → PCAC

ACLS Provider Course: Testing Scenario 3: Unstable Bradycardia > VF > Asystole > PCAC

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Participant Name:*

Date*

Testing Scenario 3: Unstable Bradycardia → VF → Asystole → PCAC

Team leader:*

AED/defibrillator operator:*

Compressor*

Airway:*

Medication administrator:*

Recorder:*

Course Date

Lead in scenario:

You are assigned to see a 52 -year-old man at the emergency department triage. He is complaining of chest pain and a feeling of suffocation. How would you manage this?

Team Actions

Performs initial impression*

Check if done correctly

Not Done Correctly

Teamwork and Communication*

Check if done correctly

Not Done Correctly

Performs primary assessment (ABCDE)*

Check if done correctly

Not Done Correctly

Provides supplemental O2 by non-rebreather mask*

Check if done correctly

Not Done Correctly

Recognizes unstable Bradycardia*

Check if done correctly

Not Done Correctly

Obtain IV access and blood sample*

Check if done correctly

Not Done Correctly

Administer atropine 1 mg IVP and verbalize to repeat the dose every 3-5 min. maximum total dose of 3mg.*

Check if done correctly

Not Done Correctly

Prepare/connect TCP /epinephrine infusion at 2- 10μg/min/dopamine infusion at 5-20 μg/min*

Check if done correctly

Not Done Correctly

Recognizes Ventricular Fibrillation*

Check if done correctly

Not Done Correctly

Assess for responsiveness, breathing and pulse*

Check if done correctly

Not Done Correctly

Initiates high-quality CPR while charging defibrillator*

Check if done correctly

Not Done Correctly

Defibrillates at appropriate dose (1st, dose)*

Check if done correctly

Not Done Correctly

Immediately resumes chest compressions*

Check if done correctly

Not Done Correctly

Defibrillates at appropriate energy (2nd , dose)*

Check if done correctly

Not Done Correctly

Administers correct dose of epinephrine*

Check if done correctly

Not Done Correctly

Considers advanced airway and capnography*

Check if done correctly

Not Done Correctly

Prepares 300 mg amiodarone*

Check if done correctly

Not Done Correctly

Identifies and treats Hs and Ts*

Check if done correctly

Not Done Correctly

Recognizes asystole*

Check if done correctly

Not Done Correctly

Immediately resumes chest compressions (High-Quality CPR)*

Check if done correctly

Not Done Correctly

Administers correct dose of epinephrine*

Check if done correctly

Not Done Correctly

Continue to discuss the Hs and Ts*

Check if done correctly

Not Done Correctly

Recognizes ROSC*

Check if done correctly

Not Done Correctly

Reassess patient: ABC*

Check if done correctly

Not Done Correctly

Consider Advance airway with capnography*

Check if done correctly

Not Done Correctly

Maintain SPO2 of 94% above*

Check if done correctly

Not Done Correctly

Manages Hemodynamics*

Check if done correctly

Not Done Correctly

Consider Targeted Temperature management*

Check if done correctly

Not Done Correctly

Verbalize the need for CT scan, ECG, laboratory*

Check if done correctly

Not Done Correctly

Seek expert consultation and transfer the patient*

Check if done correctly

Not Done Correctly

Comments

Evaluator Name*

Evaluator ID#*

Result*

Pass

Need Remediation

Comments

This field is for validation purposes and should be left unchanged.

Testing Scenario 3: Unstable Bradycardia → VF → Asystole → PCAC