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

a) Expired air contains approximately 4% carbon dioxide

b) Initially 5 breaths should be given

c) Head tilt is contraindicated in suspected cervical spine injury

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

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.

2 / 15

2. Which one of the following is the most important in the treatment of cardiac arrest

a) Delivery of supplemental oxygen

b) Therapeutic hypothermia

c) Adequate ventilation

d) Effective cardiac compression

Effective cardiac compression to maintain coronary perfusion is the most important of the choices given. Oxygenation is important, however coronary perfusion of poorly oxygenated blood is still better than no coronary perfusion of highly oxygenated blood. Ventilation is usually only required to maintain oxygenation, whilst restoration of normal acid base status is probably of no benefit and possibly harmful. Hypothermia may have a role to play following ROSC from ventricular fibrillation, but is never an initial priority.

Effective cardiac compression to maintain coronary perfusion is the most important of the choices given. Oxygenation is important, however coronary perfusion of poorly oxygenated blood is still better than no coronary perfusion of highly oxygenated blood. Ventilation is usually only required to maintain oxygenation, whilst restoration of normal acid base status is probably of no benefit and possibly harmful. Hypothermia may have a role to play following ROSC from ventricular fibrillation, but is never an initial priority.

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

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

c) 2 minutes of CPR then defibrillation

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.

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

a) It is indicated in monitored VF

b) It is indicated in children

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

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.

5 / 15

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

a) DABRCS

b) DRSCAB

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.

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6. Which one of the following statements is incorrect

a) The resting O2 consumption in an adult is 250 mL/min

b) An appropriate minute volume for a patient in cardiac arrest is 4 litres / min

c) An appropriate respiratory rate for a patient in cardiac arrest is 8/min

d) An appropriate tidal volume for a patient in cardiac arrest is 500mL

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) Deep breathing may mimic complete heart block

c) Shivering may mimic ventricular fibrillation

d) Coarse Parkinsonian tremor can mimic atrial flutter

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

a) 1.5:1

b) 2:1

c) 1:2

d) 1:1

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.

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

a) 6 minutes after CPR has commenced

b) 2 minutes after CPR has commenced

c) 8 minutes after CPR has commenced

d) 4 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.

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

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

b) It can be felt every minute during cardiac arrest

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

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

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.

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11. 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) HCO3 therapy may be indicated

c) Naloxone is an antidote for clonidine toxicity

d) Diazepam and adrenaline are antidotes for chloroquine toxicity

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

a) Amiodarone and lignocaine are highly effective

b) Amiodarone is superior to lignocaine

c) Lignocaine is superior to amiodarone

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 an adult patient with cardiac arrest, defibrillation pads should be placed

a) Apical basal

b) Basal posterior

c) Anterior posterior - with anterior being negative

d) Anterior posterior

In an adult patient with cardiac arrest, defibrillation pads should be placed apical basal. Anteroposterior placement would require interruption of CPR, which should be avoided.

In an adult patient with cardiac arrest, defibrillation pads should be placed apical basal. Anteroposterior placement would require interruption of CPR, which should be avoided.

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14. 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) Empiric K+

c) Empiric HCO3

d) High dose adrenaline

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

a) 2 minutes after CPR has commenced

b) 6 minutes after CPR has commenced

c) 4 minutes after CPR has commenced

d) 8 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.

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