Life support quiz – The Emergency Medicine Manual

This is a 15 question single best answer MCQ quiz on aspects of BLS and ALS.
Questions are taken from a bank so will be different each time the quiz is taken.

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Created on November 16, 2025 By Bob Dunn

Life support

BLS and ALS

1 / 15

1. The preferred initial sequence of management of pulseless electrical activity is which one of the following:

a) Obtain IV access / perform endotracheal intubation / commence CPR / administer adrenaline 1mg / repeat adrenaline every 4 minutes / check for treatable causes

b) Commence CPR / obtain IV access / administer adrenaline 1mg /check for treatable causes / repeat adrenaline every 4 minutes/ perform endotracheal intubation

c) Check for treatable causes / commence CPR / obtain IV access / perform endotracheal intubation / administer adrenaline 1mg / repeat adrenaline every 4 minutes

d) Commence CPR / obtain IV access / administer atropine 1mg / check for treatable causes / perform endotracheal intubation / administer adrenaline every 4 minutes

2 / 15

2. Which of the following statements about a precordial thump are correct

a) It is indicated in monitored VF

b) It is less effective in victims of high voltage electrocution

c) It is indicated in children

d) it delivers about 70 J of energy

Precordial thump is only indicated in monitored VF as if applied to pulseless VT it could precipitate VF (although pVT is only 2% of shockable rhythms). It delivers about 10-20J of energy and appears to be more effective in victims of high voltage electrocution, making it useful in mass arrests due to lightning strike.

Precordial thump is only indicated in monitored VF as if applied to pulseless VT it could precipitate VF (although pVT is only 2% of shockable rhythms). It delivers about 10-20J of energy and appears to be more effective in victims of high voltage electrocution, making it useful in mass arrests due to lightning strike.

3 / 15

3. Regarding cardiac arrest in severe hypothermia which one of the following is incorrect:

a) Anti-arrhthymic drugs are usually ineffective in severe hypothermia

b) Active core rewarming techniques should be used until body temperature exceeds 31 C before defibrillation should be attempted

c) The pulse should be felt for 30 seconds before deciding it is absent

d) Oxygen consumption is much lower in the hypothermic patient and therefore may be able to survive a more prolonged arrest than a normothermic patient

Initial defibrillation should be attempted at any temperature, but if unsuccessful, active core rewarming techniques should be used until body temperature exceeds 30 degrees then recommence defibrillation as required.

Initial defibrillation should be attempted at any temperature, but if unsuccessful, active core rewarming techniques should be used until body temperature exceeds 30 degrees then recommence defibrillation as required

4 / 15

4. In adult cardiac arrest with a shockable rhythm the second dose of adrenaline should be given at

a) 2 minutes after CPR has commenced

b) 4 minutes after CPR has commenced

c) 8 minutes after CPR has commenced

d) 6 minutes after CPR has commenced

In adult cardiac arrest with a shockable rhythm the second dose of adrenaline should be given at 6 minutes after CPR has commenced.

In adult cardiac arrest with a shockable rhythm the second dose of adrenaline should be given at 6 minutes after CPR has commenced.

5 / 15

5. Regarding cardiac arrest in pregnancy which one of the following is correct

a) The risk of pulmonary aspiration decreases with advancing gestational age

b) Displacement of the uterus to the left should occur during (and after) CPR

c) Chest compression should occur over the mid sternum to prevent damage to the fetus

d) A postmortem Caesarean section may be considered if the fetus has a gestational age of > 20 weeks / the time from arrest is < 15 min / the cause of maternal death is not haemorrhagic shock or obstetric related

6 / 15

6. Common causes of spurious rhythms may include all of the following except:

a) Coarse Parkinsonian tremor can mimic atrial flutter

b) Deep breathing may mimic complete heart block

c) Shivering may mimic ventricular fibrillation

d) Very fine VF can be misinterpreted as asystole

7 / 15

7. In relation to palpation of the pulse during cardiac arrest, which one of the following statements is incorrect:

a) It does not need to be checked whilst performing CPR

b) It should be analysed for 10 seconds in normothermic patients

c) The femoral or brachial pulse should be palpated in infants

d) It can be felt every minute during cardiac arrest

The pulse can be palpated as often as you like during CPR, however stopping CPR to perform a rhythm check should only occur 2 minutes after each intervention in ACLS, and not at all in BLS. The rhythm should be analysed for no longer than 10 seconds in normothermic patients, and 5 seconds is usually plenty.

The pulse can be palpated as often as you like during CPR, however stopping CPR to perform a rhythm check should only occur 2 minutes after each intervention in ACLS, and not at all in BLS. The rhythm should be analysed for no longer than 10 seconds in normothermic patients, and 5 seconds is usually plenty.

8 / 15

8. Match the drug doses with the following agents used in paediatric cardiac arrest

1. Amiodarone

2. Adrenaline

3. Lignocaine

4. Atropine

The correct paediatric doses are:
Adrenaline 10 microg/kg
Atropine 20 microg/kg
Amiodarone 5mg/kg
Lignocaine 1 mg/kg

The correct paediatric doses are:
Adrenaline 10 microg/kg
Atropine 20 microg/kg
Amiodarone 5mg/kg
Lignocaine 1 mg/kg

9 / 15

9. The most appropriate sedation agent for a patient with VF about to be defibrillated but who is still aware during CPR is

a) Ketamine

b) Nothing

c) Midazolam

d) Propofol

The most appropriate sedation agent for a patient with VF who is still aware during CPR is nothing. Whilst this may seem harsh, the delay to administration of any agent (allowing for circulation time) will decrease the probability of survival too much to justify.

The most appropriate sedation agent for a patient with VF who is still aware during CPR is nothing. Whilst this may seem harsh, the delay to administration of any agent (allowing for circulation time) will decrease the probability of survival too much to justify.

10 / 15

10. In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF which one of the following strategies is most likely to obtain ROSC?

a) 3 stacked shocks, 1mg adrenaline then 2 minutes of CPR if ineffective

b) 2 minutes of CPR then defibrillation

c) CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective

d) Immediate single defibrillation, then 2 minutes of CPR if ineffective

In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF, CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective is the strategy most likely to obtain ROSC. According to ILCOR guidelines (as of 2025) this strategy should be considered, but evidence suggests it is superior to the out of hospital cardiac arrest algorithm.

In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF, CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective is the strategy most likely to obtain ROSC. According to ILCOR guidelines (as of 2025) this strategy should be considered, but evidence suggests it is superior to the out of hospital cardiac arrest algorithm.

11 / 15

11. The appropriate compression : relaxation ratio for chest compressions in BLS in adults is

a) 1:2

b) 2:1

c) 1:1

d) 1.5:1

The appropriate compression : relaxation ratio for chest compressions in BLS in adults is 1:1.

The appropriate compression : relaxation ratio for chest compressions in BLS in adults is 1:1.

12 / 15

12. Regarding BLS in adults which one of the following statements is incorrect:

a) The correct location for cardiac compression is over the lower 1/2 of the sternum

b) Head tilt is contraindicated in suspected cervical spine injury

c) Expired air contains approximately 4% carbon dioxide

d) Initially 5 breaths should be given

2 breaths should be given initially. Old BLS guidelines advocated 5 initial breaths.

2 breaths should be given initially. Old BLS guidelines advocated 5 initial breaths.

13 / 15

13. The actual correct management sequence of BLS in cardiac arrest is as follows

a) DRSCAB

b) DABRCS

c) SDRABC

d) DRSABC

The actual correct sequence is Danger Response Send for help Compressions Airway Breathing. The ‘S’ was added in 2011 but unfortunately the ‘ABC’ sequence was not changed in the acronym did not change from DRSABC as this was thought to be potentially confusing for people already familiar with the ‘ABC’ sequence.

The actual correct sequence is Danger Response Send for help Compressions Airway Breathing. The ‘S’ was added in 2011 but unfortunately the ‘ABC’ sequence was not changed in the acronym did not change from DRSABC as this was thought to be potentially confusing for people already familiar with the ‘ABC’ sequence.

14 / 15

14. Regarding endotracheal drug delivery which one of the following statements is incorrect:

a) Amiodarone may be delivered via the endotracheal tube

b) Endotracheal drug delivery delivers a significant decrease & delay in peak serum levels compared with IV administration

c) 5 - 10 forceful ventilations should be given following endotracheal drug delivery

d) It should only be used if IV access is unable to be obtained after 5 minutes

Amiodarone cannot be given via ETT.

Amiodarone cannot be given via ETT.

15 / 15

15. The preferred initial sequence of management of asystole is which one of the following:

a) Commence CPR / obtain IV access / perform endotracheal intubation / administer atropine 1mg / administer adrenaline every 2 minutes

b) Commence CPR / obtain IV access / administer adrenaline 1mg / repeat adrenaline every 2 minutes/perform endotracheal intubation

c) Obtain IV access / perform endotracheal intubation / commence CPR / administer adrenaline 1mg / repeat adrenaline every 2 minutes

d) Commence CPR / obtain IV access / administer adrenaline 2mg / perform endotracheal intubation /repeat adrenaline every 2 minutes

Early intubation is most likely harmful as some interruption of CPR is usually required. It is best deferred until the patient fails to respond to initial CPR and defibrillation attempts or demonstrates ROSC. Chest compressions should only be ceased at the time the intubator is about to insert the laryngoscope into the patient’s mouth and intubation should be achieved within 10 seconds. The initial dose of adrenaline is 1mg, repeated every 2 minutes.

Early intubation is most likely harmful as some interruption of CPR is usually required. It is best deferred until the patient fails to respond to initial CPR and defibrillation attempts or demonstrates ROSC. Chest compressions should only be ceased at the time the intubator is about to insert the laryngoscope into the patient’s mouth and intubation should be achieved within 10 seconds. The initial dose of adrenaline is 1mg, repeated every 2 minutes.

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