ACLS Provider Course Testing Scenario 5: Bradycardia (3rd Degree Heart block) → PVT → Asystole → PCAC

ACLS Provider Course: Testing Scenario 5: Bradycardia (3rd Degree Heart block) > PVT > Asystole > PCAC

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Participant Name:*

Date*

Testing Scenario 5: Bradycardia (3rd Degree Heart block) → PVT → Asystole → PCAC

Team leader:*

AED/defibrillator operator:*

Compressor*

Airway:*

Medication administrator:*

Recorder:*

Course Date

Lead in scenario:

You are dispatched to a shopping mall to respond to a 62 -year-old man who suddenly had altered mental status. His wife tells you that he implanted a pacer 1 year ago. 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 ( 3rd degree heart block)*

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 Tachycardia (pulseless)*

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 energy (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 advanced 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

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Testing Scenario 5: Bradycardia (3rd Degree Heart block) → PVT → Asystole → PCAC