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ACLS Real Exam Questions - Advanced Cardiac Life Support - 2023 | Braindumps

Medical ACLS : Advanced Cardiac Life Support - 2023 Exam Dumps

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Exam Number : ACLS
Exam Name : Advanced Cardiac Life Support - 2023
Vendor Name : Medical
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ACLS Exam Format | ACLS Course Contents | ACLS Course Outline | ACLS Exam Syllabus | ACLS Exam Objectives


EXAM NUMBER : ACLS

EXAM NAME : Advanced Cardiac Life Support

Grading Scale:

91-100% = A

83-90% = B

75-82% = C

67-81% = D

Below 67 = F



Skill development for professional personnel practicing in critical care units, emergency departments, and paramedic ambulances. Establishes a system of protocols for management of the patient experiencing cardiac difficulties.



COURSE CONTENTS, COURSE OBJECTIVES, SYLLABUS

- Integrate knowledge of EMS systems, safety/well being of the paramedic, and medical/legal and ethical issues, which is intended to improve the health of EMS personnel, patients, and the community.

- Integrate knowledge of pharmacology to formulate a treatment plan intended to mitigate emergencies and improve the overall health of the patient.

- Integrate knowledge of anatomy, physiology, and pathophysiology into the exam to develop and implement a treatment plan with the goal of assuring a patent airway, adequate mechanical ventilation and respiration for all patients.

- Integrate scene and patient exam findings with knowledge of epidemiology and pathophysiology to form a field impression, differential diagnosis and formulate a treatment plan.

- Integrate comprehensive knowledge of causes and pathophysiology into the management of cardiac arrest and peri-arrest states.

- Integrate a comprehensive knowledge of the causes and pathophysiology into the management of shock, respiratory failure or arrest with an emphasis on early intervention to prevent arrest.

- Safely and effectively perform all psychomotor skills within the scope of the Paramedic practice.

- Integrates comprehensive knowledge of EMS systems, the safety/well-being of the paramedic, and medical/legal and ethical issues which is intended to improve the health of EMS personnel, patients, and the community.

- Integrates a complex depth and comprehensive breadth of knowledge of the anatomy and physiology of all human systems.

- Integrates comprehensive anatomical and medical terminology and abbreviations into the written and oral communication with colleagues and other health care professionals.

- Integrates comprehensive knowledge of pathophysiology of major human systems.

- Integrates comprehensive knowledge of life span development.

- Applies fundamental knowledge of principles of public health and epidemiology including public health emergencies, health promotion, and illness and injury prevention.

- Integrates comprehensive knowledge of pharmacology to formulate a treatment plan intended to mitigate emergencies and improve the overall health of the patient.

- Integrates complex knowledge of anatomy, physiology, and pathophysiology into the exam to develop and implement a treatment plan with the goal of assuring a patent airway, adequate mechanical ventilation, and respiration for patients of all ages.

- Integrate scene and patient exam findings with knowledge of pathophysiology to form a field impression. This includes development of a list of differential diagnoses through clinical reasoning to modify the exam and formulate a treatment plan.

- Integrates exam findings with principles of epidemiology and pathophysiology to formulate a field impression and implement a comprehensive treatment/disposition plan for a patient with a medical complaint.

- Integrates comprehensive knowledge of causes and pathophysiology into the management of the cardiac arrest and peri-arrest states.

- Integrates a comprehensive knowledge of the causes and pathophysiology into the management of shock, respiratory failure or arrest with an emphasis on early intervention to prevent arrest.

- Integrates exam findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient.

- Integrates exam findings with principles of pathophysiology and knowledge of psychosocial needs to formulate a field impression and implement a comprehensive treatment/disposition plan for patients with special needs.

- Knowledge of operational roles and responsibilities to ensure patient, public and personnel safety.

- Communicate in a culturally sensitive manner.

- Demonstrate professional behavior including but not limited to; integrity, empathy, self-motivation, appearance and personal hygiene, self confidence, communications, time-management, teamwork, diplomacy and respect, patient advocacy and the safe delivery of care.

- Safely and effectively perform all psychomotor skills within the National EMS Scope of Practice Model and state scope of practice at the Paramedic level

- Perform basic and advanced interventions as a part of a treatment plan intended to mitigate the emergency, provide symptom relief, and improve the overall health of the patient and evaluate the effectiveness of interventions and modify the treatment plan accordingly.

- Report and document exam findings and interventions. Collect and report data to be used for epidemiological and research purposes.

- Function as the team leader of a routine, single patient advanced life support emergency call.



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Medical Cardiac certification

 

Cardiac psychologists are pushing to protect heart patients’ often-overlooked mental health

Margery Quackenbush was attending a board meeting of the nonprofit where she served as executive director when she felt a sharp, stabbing pain in her chest. As the organization’s president yelled at a board member, Quackenbush — then age 69 — noticed her heart tightening and felt terrified.

After that day more than 15 years ago, her cardiologist began a series of tests. The results showed a blocked artery and she got a stent put in, becoming one of more than 600,000 people in the United States who have a stent placed each year, according to the American Heart Association.

“The whole thing came as a shock. I like to tell people I didn’t know I had a heart,” said Quackenbush, who was then the executive director of the National Association for the Advancement of Psychoanalysis. Years later, at age 85, the therapist lives in New York City’s Upper East Side in an apartment she shared with her husband of almost 50 years, children’s book author Robert Quackenbush, who died of cancer in 2021.

She became more mindful of her heart, and its needs, by attending regular support groups over the last 15 years. Today, she credits her health in part to the psychological and behavioral support she’s received while navigating heart disease — an area that’s all too often neglected in the U.S. health care system.

One in three heart patients live with anxiety, depression, and ongoing stress, according to a 2023 meta-analysis of over 100 studies. But even in the age of 24/7 monitoring via implantable loop recorders and wearables, many patients are without professional support for the mental and emotional social aspects of coping with heart disease.

“The technology of cardiology is locked down. People get that. What’s not locked down is the patient experience,” said Sam Sears, professor of health psychology at East Carolina University, and the author of over 200 research studies on psychological interventions for heart health. “The human factors in all this just don’t get addressed as a standard of care.”

Q uackenbush, however, got lucky. Reeling from surgery and seeking community with others who’d been through similar experiences, she asked her cardiologist about support groups for heart patients. In 2007, she showed up at the office of cardiac psychologist Robert Allan, whose group she still attends to this day.

On a recent Tuesday evening, Quackenbush put her feet up in her living room and logged onto Zoom from her iPad for her biweekly cardiac support group with Allan. A few members are still there from 2007, while many others have come and gone. The goal has remained the same throughout: to support each other in recovery from heart disease.

Margery Quackenbush attends Dr. Allan's virtual support group. -- health coverage from STAT Quackenbush attends cardiac psychologist Robert Allan’s virtual support group from her home. Olivia Falcigno for STAT

“Getting older is scary,” Quackenbush said of the group. “If something upsets you, you have a place you can go. You know that every other week, you are able to talk about whatever it is.”

The group offers support for healthy habits, too. Since her heart issues were first diagnosed, Quackenbush has embraced exercise, first participating in cardiac rehab, then going to a gym after the rehab center closed, then doing at-home workouts. Her current routine includes sitting down and standing up repeatedly, pelvic floor exercises, clamshells, and weight lifting. The group’s support has helped her reinforce her exercise regime and healthy cooking habits (she loves making salmon and chicken) and taught her to avoid extra stress on the heart by not eating large meals or having dinner too close to bedtime.

On this night, Quackenbush shares the impact that heated discussions about Israel and Palestine seem to be having on her physical and emotional health.

“In a [separate] discussion group I’m in, I noticed some chest pain when the group’s discussion veered toward the war in the Middle East,” Quackenbush, who lives with anxiety, shared with the group.

That was the cue for Allan to interject and ask how the news was impacting everyone. “Are you taking care of yourself while you monitor the Middle East?” he asked the group.

One member said he can’t bring himself to exercise these days. Another member said she hasn’t been getting much work done, but was OK with that considering the circumstances.

Allan aims to keep the tone of the group inclusive and encouraging even in the midst of deep discussions, posing open-ended questions and asking people to respond who haven’t had a chance to talk yet.

“I try to let the group do its own work. I sort of feel like an orchestra leader. You want to let the musicians play, you want to give them some direction,” Allan said.

For the next hour and a half, eight members shared other dispatches from their personal lives: falls, strokes, knee replacements, and even a looming cardiothoracic surgery. The group shared knowing nods and swapped experiences. One person with knee surgery on the horizon said they know they could get through it knowing another member had done it successfully in the past.

Allan has a long history in cardiac psychology. Every Tuesday and Thursday for three decades, Allan ran a psycho-educational group at Weill Cornell Medical Center’s cardiac care step-down unit for survivors of recent cardiovascular events. He worked with over 15,000 patients and family members until the Covid-19 pandemic shut the program down.

Also a member of the voluntary faculty at Weill Cornell College of Medicine, he ran pro-bono psychoeducational programs in stress and anger management at Weill Cornell’s cardiac rehabs in Manhattan, which closed in 2015, and in Queens, which closed during the pandemic. In addition to having a private practice, Allan also served as a guest instructor with the 92nd Street Y’s former cardiac rehab, where the group Quackenbush belongs to first began.

“I did this because of my own interest,” said Allan, who hasn’t had heart trouble himself. But he got into the field because he wanted to help people live differently than his father, who had his first heart attack at age 46, and whom he described as an “angry, primitive, Type A man.”

“I learned about the risk factors, and I started changing my lifestyle dramatically to avoid the same fate as my dad.”

Robert Allan, cardiac psychologist

“I learned about the risk factors, and I started changing my lifestyle dramatically to avoid the same fate as my dad,” Allan said. Then, through therapy, support groups, and psychoeducational programming, he started to teach other people to protect their hearts and minds too.

Earlier in his career, Allan came across cardiologists Meyer Friedman and Ray Rosenman’s seminal 1959 study linking type A behavior — characterized by anger and joyless striving — with an increased risk of heart attacks in men.

In the 1980s, public health specialists found type A personalities actually survived their heart attacks “better” than those with type B, results that stirred controversy in the field. Over the last 40 years, the landscape shifted from emphasizing the health risks of type A personalities to looking at the impact of other psychosocial factors — such as anxiety, depression, stress, and loneliness — on the heart. This growing body of research led Allan to discover the power of psychosocial support groups.

Support groups, Allan said, “help motivate people to change … They support healthy living through communication and validation.” When one group member says they went to the gym three times in the last week, the rest will cheer them on; if a member confesses to one too many bacon cheeseburgers, the others will groan and suggest healthier alternatives.

Psychologist Robert Allan runs a biweekly cardiac support group out of his home. -- health coverage from STAT Psychologist Robert Allan runs a biweekly cardiac support group out of his home. Olivia Falcigno for STAT

Research suggests that psychosocial factors play a role in both developing and coping with heart disease.

Depression is both a risk factor for developing cardiac disease and a risk factor after heart surgery. Worsening depression puts people at even greater risk of recurrence of heart disease, with a landmark 1993 study finding that depression can impact cardiac mortality. Research from 2017 also found depression to be a predictor of death in the first decade following a heart disease diagnosis.

Meanwhile, according to a 2022 statement from the American Heart Association, social isolation and loneliness are associated with a 30% percent increase in heart attack and stroke. Stress, too, is a concern: In a 2021 study of over 900 patients, researchers found the presence of mental stress-induced blood flow reduction, compared with no mental stress-induced reduction in blood flow, is significantly associated with an increased risk of cardiovascular death or nonfatal heart attacks.

And in a 2016 analysis of 46 studies spanning more than 2 million participants, researchers found anxiety was linked with higher risk of heart disease, stroke, and cardiovascular mortality.

“If you’re depressed, if you’re anxious, if you’re isolated, if you’re angry, you can work on those behavior patterns.”

Robert Allan, cardiac psychologist

But depression, anxiety, loneliness, and stress are not inevitable. “If you’re depressed, if you’re anxious, if you’re isolated, if you’re angry, you can work on those behavior patterns,” said Allan, who emphasizes the power of groups to reduce isolation.

In November of 2023, the American Heart Association hosted a symposium that included findings from two preliminary studies — one on how depression may accelerate cardiovascular risk factors, and one on the link between cumulative stress and plaque build-up in arteries. Cardiologist Glenn Levine emphasized in a statement the importance of screening patients for depression and anxiety: “These are things we want to aggressively refer people to mental health professionals.”

While the data on psychological risk factors for heart disease is strong, more research on what psychological interventions work in terms of health outcomes and impact on behavioral changes in the long term is needed.

That said, a meta-analysis of 14 randomized controlled trials published in 2023 found cognitive behavioral therapy, delivered individually or within a group, effectively reduced depression in patients with heart disease. And a 2017 review of 35 randomized controlled trials with a total of 10,703 participants with coronary heart disease found that people who received psychological treatment had a reduced rate of death from cardiac events, and their symptoms of depression, anxiety, and stress were alleviated. However, the review did not find evidence that psychological interventions impacted all-cause mortality.

“I’ve been struck by how, despite these positive results, how little has really found its way into the routine care of cardiac patients,” said James Blumenthal, professor in psychiatry and behavioral sciences at Duke University, speaking of his and others’ research on the profound relationship between the mind and heart.

Research by Blumenthal and his team has found that cardiac rehab programs enhanced by group stress management training resulted in lower stress and greater improvements in medical outcomes compared to standard cardiac rehab, which generally includes exercise programs and lifestyle education.

“For whatever reason, there’s been a general lack of acceptance when people say, ‘Oh, yeah, we think it’s important,’ but it has never actually made its way into the care of patients with heart disease,” Blumenthal said.

Blumenthal developed behavioral interventions delivered in group settings as an approach to psychologically-informed cardiac rehab, working with Duke’s preventive cardiology program in the 1980s on the cardiac rehab team conducting stress management groups and providing stress management via federally funded research program in the 1990s.

“Because the intervention was not covered by insurance — and was offered to patients at no cost — it was never incorporated into the routine care of patients,” Blumenthal explained via email. Duke’s cardiac rehab still evaluates patients for psychosocial risk factors for heart disease and employs a health psychologist, though it hasn’t offered formal stress management training and groups in over a decade.

The field of cardiology has often neglected mental health because it tends to place more emphasis on drugs and surgery, experts told STAT. Another issue is that cardiac rehab programs are not a moneymaker for hospitals, since program costs can exceed revenue as hospitals push for more streamlined at-home rehab delivery. Even for hospitals that do offer cardiac rehab, it’s unclear what percentage of the 1,337 cardiac rehab programs registered through American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) offer psychological support.

“There are pockets of successful integration of psychology and cardiology, and then there are places that are deserts,” said Sears. “Until we give everyone equal access and have equal buy-in from cardiology, it’ll be hard for us to see the full success of that type of integration. Instead, we see it center by center instead of state by state.”

Sears’ Cardiac Psychology Lab is part of East Carolina University’s Clinical Health Psychology program, one of seven graduate schools focused on the psychology of medicine. There, he trains cardiologists on building resilience and reducing burnout in their work, and shares a clinic and cardiac rehab with cardiologists at East Carolina Heart Institute.

“The needs of the patient are more than just what a physician and the nurse can deliver.”

Matthew Burg, clinical psychologist and professional of cardiovascular medicine

“We need a whole new approach to cardiovascular care. And we need the funding initiatives to develop and test those new models of care,” said Matthew Burg, clinical psychologist and professional of cardiovascular medicine at Yale School of Medicine.

Burg is a founding member of the Society of Behavioral Medicine’s Cardiovascular Disease Special Interest Group, where there are over 300 psychologists and cardiologists interested in advancing what they refer to as the field of cardiovascular behavioral medicine.

One big obstacle to greater psychological support for cardiac patients is training: Cardiologists often haven’t been trained to work in a team context with psychologists, and vice versa. That’s why psychologists such as Burg and Sears teach courses for future cardiologists and encourage psychologists to seek more training in cardiology.

“It’s not just about, we need integrated cardiovascular care so that we start to address mental health issues. It’s that we need integrated cardiovascular care, because the needs of the patient are more than just what a physician and the nurse can deliver,” said Burg.

Margery Quackenbush performs cardiac health exercises on her living room floor. -- health coverage from STAT Quackenbush performs cardiac health exercises daily in her Upper East Side apartment. Olivia Falcigno for STAT

Some progress is underway. Last November, over 100 heart patients showed up to a conference room where the launch of a new cardiac support group at Brigham and Women’s Hospital in Boston, Massachusetts, was hosted by physician assistants Tiffany Andrade and Lauren Rousseau. Brigham and Women also recently launched a department of cardiovascular psychiatry, led by psychiatrist Margo Funk, that offers mental health resources to patients.

Sears was a featured speaker for the Brigham and Women support group launch and delivered a talk called “How to Make a Cardiac Comeback,” complete with a theme song: “Comeback Story” by Kings of Leon. His lively talk included references to Mick Jagger’s transaortic valve replacement and Christian Ericksen, the Denmark soccer star who had a defibrillator implanted after collapsing from cardiac arrest at a Euro 2020 soccer match. He showed photos of what he calls “cardiac swag” — people with tattoos of defibrillators and T-shirts with inspirational slogans like “I Survived Open Heart Surgery. What’s Your Superpower?”

Sears, who compared his style to that of a sergeant and oscillates between offering inspiration and reassurance, tries to impart his audience with motivation for resuming activity after a cardiac event.

“Cardiac arrest is a significant medical trauma,” said Sears. The goal of his work, he added, is “to transform the most threatening, scariest day of their life into something that empowers you to be stronger.”

“A core element about heart disease is that it leads people to believe that they can disengage as a self-protective response.”

Sam Sears, professor of health psychology

Sears’ cardiac rehab has been in practice for 16 years. At East Carolina, patients undergo six to 10 sessions of cognitive behavioral therapy, including discussions around how to manage the experience of shock from defibrillator implants while reducing symptoms of PTSD and building “active problem-oriented coping skills” shown to increase quality of life, such as making time for family, setting health goals, and engaging in safe exercise.

“A core element, psychologically and physically, about heart disease is that it leads people to believe that they can disengage as a self-protective response,” Sears said. “And the opposite is true. The more engaging they are about the disease, the more engaging they are about what’s going on in their life to be more deliberate in their behaviors and their emotions, the more likely they are to find peace and quality of life on the other side.”

Learning to be deliberate about, and engaged with, her emotions and health has been a major force for change for Quackenbush. Last year, her heart started to beat faster than normal and she was diagnosed with a condition called atrial flutter. Her doctor told her it wasn’t life-threatening.

“Well, when it’s your life, it’s different,” Quackenbush said of the experience when it came up in a recent support group conversation.

A grandmother of two, Quackenbush leads a robust social life, filled with lunches with girlfriends and dating. Every night, she exchanges a photo of her dinner with one of the men she dates. But her cardiac group remains a cornerstone — she even attended a support group on vacation on her iPhone, declining a dinner invitation to do so.

Reflecting on her recovery from heart disease, Quackenbush said, “What would I tell myself when I was in my late 60s? You’re going to survive. You have the support group.”

This story is the latest in a series on the U.S. mental health system, supported by a grant from the NIHCM Foundation. Our financial supporters are not involved in any decisions about our journalism.


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Ask the Pediatrician: How can schools prepare for sudden cardiac arrest?

Did you know sudden cardiac arrest is the main cause of death in young athletes? This fact may be surprising. But it has prompted 43 states to require cardiopulmonary resuscitation (CPR) training for all high school students before graduation. In addition, many states now require automated external defibrillators (AEDs) in schools.

What happens with sudden cardiac arrest?

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Sudden cardiac arrest is when the heart suddenly stops beating. It can cause death within minutes. Certain conditions can lead to sudden cardiac arrest, but not all the causes are known.

Sudden cardiac arrest is rare in young people. When it happens, it’s often to young athletes during competition or practice. But sudden cardiac arrest can happen at any time to any young person, even if they aren’t in sports.

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When a person’s heart stops beating, quick action can mean the difference between life or death. CPR and AEDs save lives.

An AED checks the heart rhythm. If needed, it sends a shock that will get the rhythm back to normal. It won’t shock a person if they don’t need it.

According to the American Heart Association, about 9 in 10 people who get a shock from an AED within the first minute of cardiac arrest live. For every minute that passes in cardiac arrest, the chance of survival goes down by 10%.

The American Academy of Pediatrics advises all schools to place AEDs both inside and outside on school grounds as part of a cardiac emergency response plan. It should take no more than two minutes to get an AED and return to the victim.

At least 20 states plus the District of Columbia require AEDs to be in all public schools. In California, schools that offer sports must supply AEDs too.

Even if your state doesn’t mandate AEDs, you can still be an advocate for getting them at your school. Having AEDs available may just save someone’s life.

Although using an AED may seem intimidating, it will tell you if a shock is needed or not. You can even take a hospital or community CPR class to learn more about how to do CPR and how to use an AED.

Some young people may not have symptoms of heart problems until the sudden cardiac arrest occurs.

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Others may experience heart-related symptoms before sudden cardiac arrest, such as:

  • Chest pain
  • Lightheadedness
  • Dizziness
  • Shortness of breath
  • Feeling that your heart is racing
  • Fainting, especially during exercise
  • These symptoms could indicate a serious underlying heart condition.

    The AAP recommends that pediatricians should screen all kids for heart-related issues, not just athletes. This screening could help identify conditions that can lead to sudden cardiac arrest.

    The AAP also recommends that all kids — from middle school to college age — have an annual sports physical. This can be scheduled alongside their yearly well-child visit with their pediatrician. Even if your child isn’t playing organized sports, they will benefit from this thorough exam, which examines heart health.

    Of course, if you or your child have any concerns about their heart health, see your pediatrician or a pediatric cardiologist.

    ———

    Advertisement

    Alex B. Diamond, DO, MPH, FAAP, FAMSSM, a member of the American Academy of Pediatrics Council on Sports Medicine & Fitness, is an associate professor of orthopaedic surgery, pediatrics and neurological surgery at Vanderbilt University Medical Center. He is also director of the Vanderbilt Youth Sports Center and team physician for Vanderbilt University and the Nashville Predators.

    Stuart Berger, MD, FAAP, chair of the American Academy of Pediatrics Section on Cardiology & Cardiac Surgery, is division head of pediatric cardiology and Lurie Children’s Hospital.


     


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