New life support quiz – The Emergency Medicine Manual

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Created on November 16, 2025 By Bob Dunn

Life support

BLS and ALS

1 / 15

1. In out of hospital adult cardiac arrest with a shockable rhythm the third shock will be delivered at

a) 6 minutes after CPR has commenced

b) 8 minutes after CPR has commenced

c) 2 minutes after CPR has commenced

d) 4 minutes after CPR has commenced

In out of hospital adult cardiac arrest with a shockable rhythm the third shock will be delivered at 4 minutes after CPR has commenced.

In out of hospital adult cardiac arrest with a shockable rhythm the third shock will be delivered at 4 minutes after CPR has commenced.

2 / 15

2. In cardiac arrest due to ventricular fibrillation in adults, which one of the following management sequences is preferred:

a) Commence CPR / apply monitor to determine rhythm / defibrillate

b) Commence CPR / apply monitor to determine rhythm / perform endotracheal intubation / defibrillate

c) Perform endotracheal intubation / commence CPR / apply monitor to determine rhythm / defibrillate

d) Commence CPR / establish IV access / apply monitor to determine rhythm / defibrillate

In cardiac arrest due to ventricular fibrillation in adults the following sequence is preferred: Commence external cardiac massage / apply monitor to determine rhythm / defibrillate.

In cardiac arrest due to ventricular fibrillation in adults the following sequence is preferred: Commence external cardiac massage / apply monitor to determine rhythm / defibrillate.

3 / 15

3. In adult cardiac arrest with a shockable rhythm adrenaline should first be given

a) 6 minutes after CPR has commenced

b) Immediately on recognition of cardiac arrest

c) 2 minutes after CPR has commenced

d) 4 minutes after CPR has commenced

In adult cardiac arrest with a shockable rhythm adrenaline should first be given 2 minutes after CPR has commenced.

In adult cardiac arrest with a shockable rhythm adrenaline should first be given 2 minutes after CPR has commenced.

4 / 15

4. How much does the effectiveness of defibrillation in terminating VF decrease by each minute of delay?

a) 15%

b) 5%

c) 10%

d) 1%

The effectiveness of defibrillation in terminating VF decreases by about 15% for each minute of delay.

The effectiveness of defibrillation in terminating VF decreases by about 15% for each minute of delay.

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

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

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

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.

6 / 15

6. During CPR, the effectiveness of the operator performing chest compression usually starts to reduce between

a) 1-2 min

b) 2-3 min

c) 0-1 min

d) 3-4 min

A 10-20% reduction in compression depth occurs by 90 sec., despite operators not necessarily feeling fatigued. This is the reason that changing operators at least every 2 minutes (usually at the time of rhythm check) is required.

A 10-20% reduction in compression depth occurs by 90 sec., despite operators not necessarily feeling fatigued. This is the reason that changing operators at least every 2 minutes (usually at the time of rhythm check) is required.

7 / 15

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

a) Very fine VF can be misinterpreted as asystole

b) Coarse Parkinsonian tremor can mimic atrial flutter

c) Shivering may mimic ventricular fibrillation

d) Deep breathing may mimic complete heart block

8 / 15

8. Regarding cardiac arrest following poisoning which one of the following statements is incorrect:

a) The prognosis for most patients with poisoning is worse than that of older patients with cardiogenic cardiac arrest

b) Diazepam and adrenaline are antidotes for chloroquine toxicity

c) HCO3 therapy may be indicated

d) Naloxone is an antidote for clonidine toxicity

9 / 15

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

a) DRSCAB

b) SDRABC

c) DABRCS

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.

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

a) Propofol

b) Ketamine

c) Midazolam

d) Nothing

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.

11 / 15

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

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

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

12 / 15

12. Which one of the following statements regarding drug therapy in ALS for shockable rhythms is correct

a) Amiodarone is superior to lignocaine

b) Lignocaine is superior to amiodarone

c) Amiodarone and lignocaine are highly effective

d) Amiodarone and lignocaine are similarly effective

In shockable rhythms that have failed defibrillation attempts and adrenaline, lignocaine and amiodarone are considered of equal (but low) effectiveness.

In shockable rhythms that have failed defibrillation attempts and adrenaline, lignocaine and amiodarone are considered of equal (but low) effectiveness.

13 / 15

13. In adult cardiac arrest due to VF unresponsive to standard BLS/ALS treatment, which one of the following is most likely to be of benefit

a) Vector change defibrillation

b) High dose adrenaline

c) Empiric K+

d) Empiric HCO3

In adult cardiac arrest due to VF unresponsive to standard BLS/ALS treatment, vector change defibrillation is most likely to be of benefit - although limited. The other treatments are all associated with even worse outcomes than expected.

In adult cardiac arrest due to VF unresponsive to standard BLS/ALS treatment, vector change defibrillation is most likely to be of benefit - although limited. The other treatments are all associated with even worse outcomes than expected.

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14. In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately

a) 12 minutes

b) 4 minutes

c) 10 minutes

d) 7 minutes

In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately 7 minutes. This means there is significant organ hypoxia and acidosis that is not present in in hospital witnessed cardiac arrests.

In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately 7 minutes. This means there is significant organ hypoxia and acidosis that is not present in in hospital witnessed cardiac arrests.

15 / 15

15. Which one of the following statements is indicative of the correct CPR technique in an adult:

a) The rate of compression should be at least 80/min in adults

b) Compression should comprise 50% of the cycle

c) The depth of compression should be approximately 1/5 of the thoracic diameter

d) The ventilation : compression ratio should be 2:5

Depth of compression should be 5 – 6cm (>1/3 of the thoracic diameter). Ventilation compression ratio should be 2:30. The compression rate should be 100-120/min.

Depth of compression should be 5 – 6cm (>1/3 of the thoracic diameter). Ventilation compression ratio should be 2:30. The compression rate should be 100-120/min.

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