NLE Emergency & Critical Care Nursing — Basic & Advanced Life Support (CPR/ACLS)Exam Answer Templates

Marks

1

Topic

BLS — Compression-to-Ventilation Ratio

Difficulty

easy

Template Id

T1

Examiner Tip

The examiner is testing whether you can distinguish between single-rescuer and two-rescuer ratios, and between adult and pediatric protocols. One correct number pair is all that is needed for 1 mark — do not over-explain.

Model Answer

The correct adult compression-to-ventilation ratio during single-rescuer CPR is 30:2 (30 compressions followed by 2 breaths).

Question Type

very_short_answer

Answer Structure

• State the ratio as a number pair (30:2) [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing '15:2' — this applies only to two-rescuer CPR on a child or infant, not single-rescuer adult
• Writing '30:1' or '15:1' — incorrect ratios
• Not specifying the context (single rescuer) when the question asks for it

Key Phrases To Include

• 30:2
• 30 compressions
• 2 breaths
• single rescuer

Marks

1

Topic

BLS — High-Quality Chest Compressions

Difficulty

easy

Template Id

T2

Examiner Tip

This is a pure recall question. The examiner wants two precise numeric ranges. Write both on one line to save time.

Model Answer

The acceptable compression rate for adults is 100 to 120 compressions per minute, and the depth is at least 5 cm (2 inches) but not more than 6 cm (2.4 inches).

Question Type

very_short_answer

Answer Structure

• State the rate range (100-120/min) — ½ mark
• State the depth range (≥5 cm, ≤6 cm) — ½ mark

Scoring Breakdown

Common Mark Deductions

• Stating only rate without depth, or vice versa
• Writing '>100' without the upper limit — this misses the ceiling of 120
• Writing 'deep compressions' without citing the actual centimeter measurement

Key Phrases To Include

• 100 to 120 per minute
• at least 5 cm
• not more than 6 cm
• 2 inches

Marks

2

Topic

Choking — Foreign-Body Airway Obstruction

Difficulty

easy

Template Id

T3

Examiner Tip

Examiners award marks for the contrast between the two conditions. Use a clear structure: Mild = signs + action; Severe = signs + action. A table format saves time and shows clarity.

Model Answer

In MILD obstruction, the patient can cough forcefully, speak, or wheeze. The nurse should encourage continued forceful coughing and observe — no physical intervention is performed. In SEVERE obstruction, the patient cannot speak, cough, or breathe, and may display the universal choking sign (clutching the throat) and cyanosis. The nurse immediately performs abdominal thrusts (Heimlich maneuver) — quick inward and upward thrusts above the navel and below the xiphoid — and continues until the object is expelled or the patient becomes unresponsive.

Question Type

short_answer

Answer Structure

• Line 1: Define mild obstruction — key signs (able to cough, speak, wheeze) [½ mark]
• Line 2: State nursing action for mild obstruction (encourage coughing, do not intervene) [½ mark]
• Line 3: Define severe obstruction — key signs (cannot speak/cough/breathe, choking sign, cyanosis) [½ mark]
• Line 4: State nursing action for severe obstruction (abdominal thrusts, describe technique) [½ mark]

Scoring Breakdown

Common Mark Deductions

• Performing abdominal thrusts on a mild obstruction — this is incorrect and dangerous
• Failing to specify the landmark for abdominal thrusts (above navel, below xiphoid)
• Not mentioning what to do when the victim becomes unresponsive (start CPR)

Key Phrases To Include

• forceful cough
• cannot speak
• universal choking sign
• cyanosis
• abdominal thrusts
• Heimlich maneuver
• inward and upward
• above navel below xiphoid

Marks

2

Topic

BLS — C-A-B Sequence

Difficulty

easy

Template Id

T4

Examiner Tip

The shift from A-B-C to C-A-B is a high-yield NLE concept. Always state C-A-B explicitly and explain the rationale briefly: compressions circulate the residual oxygenated blood already present at arrest.

Model Answer

The adult BLS sequence follows C-A-B: (1) Ensure scene safety, then tap and shout to check responsiveness. (2) Simultaneously assess for breathing and pulse for no more than 10 seconds — agonal gasping counts as no breathing. (3) Activate the emergency response system and retrieve an AED. (4) Begin high-quality chest compressions immediately (rate 100-120/min, depth ≥5 cm). (5) After 30 compressions, open the airway using head-tilt/chin-lift and deliver 2 rescue breaths. Continue cycles of 30:2.

Question Type

short_answer

Answer Structure

• Step 1: Scene safety and responsiveness check [½ mark]
• Step 2: Simultaneous breathing and pulse check, ≤10 seconds, agonal = no breathing [½ mark]
• Step 3: Activate EMS + get AED [½ mark]
• Step 4-5: C then A then B with correct parameters [½ mark]

Scoring Breakdown

Common Mark Deductions

• Writing A-B-C instead of C-A-B — this is a fundamental error
• Checking pulse first without simultaneously checking breathing
• Omitting scene safety step
• Not recognizing agonal breathing as absent breathing

Key Phrases To Include

• C-A-B
• scene safety
• 10 seconds
• agonal gasping
• 100 to 120 per minute
• at least 5 cm
• 30:2
• head-tilt chin-lift

Marks

3

Topic

BLS — Pediatric and Infant CPR

Difficulty

medium

Template Id

T5

Examiner Tip

Pediatric CPR questions almost always test the depth and ratio differences. A table comparing adult, child, and infant is an excellent way to answer these questions clearly and efficiently.

Model Answer

For a 6-month-old infant (under 1 year): HAND POSITION — with a single rescuer, use two fingers placed on the lower half of the sternum, just below the nipple line. With two rescuers, use the two-thumb encircling technique, where both thumbs compress the sternum while the hands encircle the chest. DEPTH — compress approximately one-third the anteroposterior (AP) diameter of the chest, which is approximately 4 cm (1.5 inches). RATE — 100 to 120 compressions per minute. RATIO — single rescuer uses 30:2; two rescuers use 15:2. Full chest recoil must be allowed between compressions, and interruptions must be minimized.

Question Type

short_answer

Answer Structure

• State hand position for single rescuer (two fingers, lower sternum) [1 mark]
• State hand position for two rescuers (two-thumb encircling technique) [½ mark]
• State correct depth (~4 cm, one-third AP diameter) [½ mark]
• State rate (100-120/min) and ratio modification for two rescuers (15:2) [1 mark]

Scoring Breakdown

Common Mark Deductions

• Using adult technique (heel of hand) on an infant — dangerous and wrong
• Stating depth as '5 cm' (this is the child depth; infant is ~4 cm)
• Keeping the 30:2 ratio for two rescuers (two-rescuer infant and child CPR uses 15:2)
• Forgetting to mention full chest recoil

Key Phrases To Include

• two fingers
• lower sternum
• two-thumb encircling
• one-third anteroposterior diameter
• 4 cm
• 15:2
• 100 to 120 per minute
• full chest recoil

Marks

3

Topic

ACLS — Reversible Causes (Hs and Ts)

Difficulty

medium

Template Id

T6

Examiner Tip

The Hs and Ts are high-yield in NLE. Write them as a numbered list under two headings (Hs / Ts) — this shows organization and makes it easy for the examiner to check off each point. Examiners award partial marks, so even if you miss one, you still score.

Model Answer

The reversible causes of cardiac arrest are remembered using the Hs and Ts: THE Hs — (1) Hypovolemia, (2) Hypoxia, (3) Hydrogen ion excess (Acidosis), (4) Hypo-/Hyperkalemia, (5) Hypothermia. THE Ts — (6) Tension pneumothorax, (7) Tamponade (cardiac), (8) Toxins (drug overdose/poisoning), (9) Thrombosis — pulmonary (pulmonary embolism) or coronary (acute MI). Identifying and treating these causes is essential in all arrests, especially non-shockable rhythms (asystole and PEA).

Question Type

short_answer

Answer Structure

• List all 5 Hs with correct terminology [1.5 marks]
• List all 4 Ts with correct terminology [1.5 marks]

Scoring Breakdown

Common Mark Deductions

• Listing only Hs or only Ts
• Writing 'hyperkalemia' only — the question covers both hypo and hyperkalemia
• Confusing 'thrombosis' by naming only one type (must mention both pulmonary and coronary)
• Forgetting hypothermia or tamponade — these are frequently missed

Key Phrases To Include

• Hypovolemia
• Hypoxia
• Hydrogen ion (acidosis)
• Hypo-/Hyperkalemia
• Hypothermia
• Tension pneumothorax
• Tamponade
• Toxins
• Thrombosis
• pulmonary embolism
• acute MI

Marks

3

Topic

AED — Automated External Defibrillator

Difficulty

medium

Template Id

T7

Examiner Tip

Step-by-step numbered answers earn marks systematically. The examiner checks each step off a marking scheme — use a numbered list so no step is missed. The most commonly tested point is that you resume CPR IMMEDIATELY after the shock, not pulse-check first.

Model Answer

AED USE — STEP-BY-STEP: (1) POWER ON: Turn on the AED immediately upon arrival; follow voice and visual prompts. (2) ATTACH PADS: Expose the chest; ensure it is bare and dry. Place one pad below the right clavicle (upper right chest) and one pad on the left lower lateral chest (left side, below armpit level). (3) ANALYZE: Stop compressions and ensure no one is touching the patient while the AED analyzes the rhythm. (4) SHOCK: If a shock is advised, verbally and visually clear the patient ('Clear!') and deliver the shock. (5) RESUME CPR: Immediately resume chest compressions for 2 minutes after the shock before re-analyzing the rhythm — do not pause to check pulse right after a shock. SPECIAL CONSIDERATIONS: Remove transdermal medication patches and wipe the site dry before pad placement; place pads at least 2.5 cm from implanted pacemakers; use pediatric pads/attenuator for children if available.

Question Type

short_answer

Answer Structure

• Step 1-2: Power on and correct pad placement with anatomical landmarks [1 mark]
• Step 3: Clear and analyze — nobody touching during analysis [½ mark]
• Step 4: Clear and shock [½ mark]
• Step 5: Immediately resume CPR for 2 minutes before re-check [1 mark]

Scoring Breakdown

Common Mark Deductions

• Checking pulse immediately after a shock before resuming compressions — incorrect
• Vague pad placement (e.g., 'on the chest') without anatomical landmarks
• Forgetting to clear the patient before delivering the shock
• Not mentioning the 2-minute CPR cycle after defibrillation

Key Phrases To Include

• below the right clavicle
• left lower lateral chest
• bare and dry
• no one touching
• Clear!
• immediately resume compressions
• 2 minutes
• transdermal patch

Marks

2

Topic

ACLS — Pharmacology (Epinephrine)

Difficulty

medium

Template Id

T8

Examiner Tip

This is one of the highest-yield NLE drug questions in ACLS. Examiners specifically set this to trap students who confuse the two concentrations. Write both side by side for easy comparison. Remembering the mnemonic: '10,000 is ten times more dilute' helps prevent errors.

Model Answer

CARDIAC ARREST (ACLS): Epinephrine 1 mg IV/IO every 3 to 5 minutes, using the 1:10,000 concentration (1 mg in 10 mL). This is given for both shockable rhythms (after the second shock) and non-shockable rhythms (as early as possible). ANAPHYLAXIS: Epinephrine 0.3 to 0.5 mg IM, using the 1:1,000 concentration (1 mg in 1 mL), administered in the anterolateral thigh. KEY DIFFERENCE: The arrest concentration (1:10,000) is 10 times MORE DILUTE than the anaphylaxis concentration (1:1,000). Confusing the two concentrations is a critical medication error.

Question Type

short_answer

Answer Structure

• State arrest dose and concentration (1 mg IV/IO q3-5 min, 1:10,000) [1 mark]
• State anaphylaxis dose and concentration (0.3-0.5 mg IM, 1:1,000) and note the key difference [1 mark]

Scoring Breakdown

Common Mark Deductions

• Confusing concentrations (using 1:1,000 for arrest) — a critical patient safety error
• Forgetting the frequency (every 3-5 minutes)
• Not specifying the route (IV/IO for arrest, IM for anaphylaxis)
• Giving an incorrect dose range for anaphylaxis

Key Phrases To Include

• 1 mg IV/IO
• every 3 to 5 minutes
• 1:10,000
• 0.3 to 0.5 mg IM
• 1:1,000
• anaphylaxis
• anterolateral thigh

Marks

2

Topic

ACLS — Rhythm Recognition and Treatment

Difficulty

medium

Template Id

T9

Examiner Tip

This question tests the most fundamental ACLS branch point. The key rule: SHOCK the chaos (VF/pVT), do NOT shock the silence (asystole) or the organized-but-no-pulse (PEA). Say this to yourself during practice.

Model Answer

SHOCKABLE RHYTHMS — Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (pVT): These are chaotic or rapid rhythms with no effective cardiac output. Treatment: Immediate defibrillation (unsynchronized shock), followed by 2 minutes of CPR, then rhythm reassessment. Epinephrine 1 mg IV/IO is given after the second shock, and amiodarone 300 mg IV/IO is added for rhythms refractory to defibrillation. NON-SHOCKABLE RHYTHMS — Asystole (flat line) and Pulseless Electrical Activity (PEA): These rhythms are NOT shocked. Treatment: Immediate high-quality CPR plus epinephrine 1 mg IV/IO every 3-5 minutes (given as early as possible), while searching for and correcting reversible causes (Hs and Ts).

Question Type

short_answer

Answer Structure

• Name shockable rhythms (VF, pVT) and state initial treatment (defibrillation) [1 mark]
• Name non-shockable rhythms (asystole, PEA) and state treatment (CPR + epinephrine, no shock, Hs and Ts) [1 mark]

Scoring Breakdown

Common Mark Deductions

• Shocking asystole — a critical error, asystole is never shocked
• Forgetting PEA in the non-shockable category
• Not mentioning the Hs and Ts for non-shockable rhythms
• Confusing synchronized cardioversion (for stable tachycardia) with defibrillation (for arrest)

Key Phrases To Include

• ventricular fibrillation
• pulseless ventricular tachycardia
• defibrillation
• asystole
• pulseless electrical activity
• do not shock
• epinephrine
• reversible causes
• Hs and Ts

Marks

1

Topic

BLS — High-Quality CPR Principles

Difficulty

easy

Template Id

T10

Examiner Tip

This is a physiology-application question. The examiner wants to see that you understand WHY, not just that you know TO allow recoil. One sentence linking the action to the physiological consequence is sufficient for 1 mark.

Model Answer

Full chest recoil allows the heart to refill with blood between compressions, generating adequate preload. If the rescuer leans on the chest, this prevents complete recoil, reduces venous return to the heart, decreases cardiac output, and lowers the effectiveness of CPR.

Question Type

very_short_answer

Answer Structure

• State the purpose of full recoil (heart refills, preload maintained) and consequence of leaning (reduced venous return, decreased output) [1 mark]

Scoring Breakdown

Common Mark Deductions

• Saying 'it prevents injury' — while true, this is not the primary physiological reason
• Not explaining the physiological mechanism (preload/venous return)

Key Phrases To Include

• full chest recoil
• venous return
• preload
• cardiac output
• leaning reduces effectiveness

Marks

2

Topic

Choking — Special Populations

Difficulty

hard

Template Id

T11

Examiner Tip

Special population questions (pregnant, obese, infant) are high-yield in NLE because they test adaptation of standard protocols. Always state WHY the standard intervention changes before describing the alternative — this shows clinical reasoning.

Model Answer

Because this patient is pregnant, abdominal thrusts (Heimlich maneuver) are CONTRAINDICATED due to the risk of harming the fetus and uterus. The correct intervention is CHEST THRUSTS: (1) Stand behind the patient. (2) Place your fist on the CENTER OF THE STERNUM (not the abdomen). (3) Deliver firm, backward chest thrusts until the foreign body is expelled or the patient becomes unresponsive. If she becomes unresponsive, lower her to the ground, activate the emergency response system, and begin CPR starting with chest compressions. Each time the airway is opened for rescue breaths, look in the mouth and remove any visible object — never perform a blind finger sweep.

Question Type

short_answer

Answer Structure

• Identify why abdominal thrusts are contraindicated in pregnancy [½ mark]
• Describe correct intervention: chest thrusts, sternal placement [1 mark]
• State action if patient becomes unresponsive (CPR, remove only visible objects, no blind sweep) [½ mark]

Scoring Breakdown

Common Mark Deductions

• Performing abdominal thrusts on a pregnant patient — contraindicated and dangerous
• Not specifying the correct landmark for chest thrusts (sternum, not abdomen)
• Performing a blind finger sweep — this can push the object deeper

Key Phrases To Include

• chest thrusts
• center of sternum
• pregnant
• abdominal thrusts contraindicated
• CPR
• visible object
• no blind finger sweep

Marks

3

Topic

ACLS — Team Dynamics and Communication

Difficulty

medium

Template Id

T12

Examiner Tip

Team dynamics questions are increasingly common in NLE as they reflect real code blue scenarios in Philippine hospitals. The examiner rewards students who demonstrate understanding that resuscitation is a TEAM effort, not an individual act. Use clinical Philippine context: BLS trained nurses under RA 9173 have a duty to initiate CPR.

Model Answer

Effective resuscitation team dynamics rest on three pillars: CLEAR ROLE ASSIGNMENT — A designated team leader directs the code, verbalizes the treatment plan, monitors the rhythm and elapsed time, and coordinates all team members. Each member is assigned a specific role (compressor, airway manager, IV access, timekeeper, recorder). CLOSED-LOOP COMMUNICATION — The team leader gives an explicit order (e.g., 'Give epinephrine 1 mg IV now'), the receiver repeats the order back to confirm understanding, and verbally confirms completion ('Epinephrine 1 mg IV given'). This prevents missed doses, double-dosing, and errors in the noise of a resuscitation. MUTUAL MONITORING AND SPEAKING UP — Any team member may and must speak up if they observe a lapse in compression quality, a prolonged interruption, or a potential medication error. A safety culture where anyone can flag a concern saves lives. DEBRIEFING — After the event, the team reviews what went well and what to improve for future codes.

Question Type

short_answer

Answer Structure

• Describe the role of the team leader and role assignment [1 mark]
• Explain closed-loop communication with a concrete example [1 mark]
• Describe mutual monitoring and speaking up culture; mention debriefing [1 mark]

Scoring Breakdown

Common Mark Deductions

• Describing closed-loop communication without showing all three steps (order → repeat → confirm)
• Omitting the team leader concept
• Focusing only on individual skills rather than team dynamics

Key Phrases To Include

• designated team leader
• role assignment
• closed-loop communication
• repeat back
• confirm completion
• speaking up
• debriefing
• mutual monitoring

Marks

5

Topic

Integrated BLS/ACLS — Nursing Process Application

Difficulty

hard

Template Id

T13

Examiner Tip

Long-answer case studies test integration of knowledge. The examiner follows the nursing process format and awards marks for each step. A student who writes excellent implementation but skips assessment and diagnosis loses 2 marks. Use clear subheadings: Assessment / Diagnosis / Planning / Implementation / Evaluation. In Philippine nursing licensure context, note that RA 9173 mandates that registered nurses be competent in emergency care — citing this in your introduction sentence shows awareness of professional responsibility.

Model Answer

ASSESSMENT: Nurse Reyes verifies scene safety, then taps the patient's shoulders and shouts 'Sir, are you okay?' to confirm unresponsiveness. She simultaneously assesses for breathing (looking for chest rise, listening for breath sounds, feeling for airflow) and palpates the carotid pulse for no more than 10 seconds. She identifies agonal gasping (counts as absent breathing) and absent carotid pulse. NURSING DIAGNOSIS (NANDA): Decreased Cardiac Output related to cardiac arrest, as evidenced by absent pulse and apnea. Ineffective Tissue Perfusion (cerebral, cardiac) related to cessation of circulation. PLANNING AND PRIORITY INTERVENTION (Maslow — Physiological/Survival): Because this is a life-threatening emergency, physiological survival is the highest priority per Maslow's hierarchy. IMPLEMENTATION — STEP BY STEP: (1) ACTIVATE EMS: Shout for help, pull the emergency call, and direct a bystander to call the Code Blue team and retrieve the AED. She places the phone on speaker if alone to alert colleagues. (2) BEGIN CHEST COMPRESSIONS IMMEDIATELY (C of C-A-B): Positions hands with heel on lower half of sternum, compresses at 100-120 per minute to a depth of at least 5 cm, allowing full chest recoil, maintaining 30:2 ratio with rescue breaths, minimizing interruptions. (3) OPEN AIRWAY (A): After 30 compressions, performs head-tilt/chin-lift (no trauma suspected). (4) RESCUE BREATHING (B): Delivers 2 breaths over 1 second each with visible chest rise; avoids over-ventilation. (5) AED: When the AED arrives, applies it immediately — pads to bare dry chest (right subclavian area and left lower lateral), clears all personnel during rhythm analysis, delivers shock if advised, and immediately resumes compressions for 2 minutes before re-analysis. (6) CONTINUED CYCLES: Switches compressor every 2 minutes to maintain compression quality. Prepares for ACLS with IV access, medication preparation, and advanced airway support upon team arrival. EVALUATION: Return of spontaneous circulation (ROSC) is confirmed by resumption of a palpable pulse, spontaneous breathing, and improvement in end-tidal CO₂ reading. Post-ROSC care focuses on airway management, blood pressure support, targeted temperature management, and identification of precipitating cause.

Question Type

long_answer

Answer Structure

• Assessment: scene safety, responsiveness, simultaneous breathing and pulse check ≤10 seconds, recognize agonal breathing [1 mark]
• Nursing diagnosis: at least one NANDA-based diagnosis with etiology and defining characteristics [1 mark]
• Priority rationale: Maslow physiological survival as highest priority [½ mark]
• Implementation: correct C-A-B sequence with parameters (rate, depth, ratio, recoil, minimize interruptions) [1.5 marks]
• AED use: correct pad placement, clear, shock, immediate CPR resumption [½ mark]
• Evaluation: ROSC criteria and post-arrest care plan [½ mark]

Scoring Breakdown

Common Mark Deductions

• Starting with breathing or airway before compressions (writing A-B-C instead of C-A-B)
• Omitting the Maslow prioritization framework — this is expected in nursing process answers
• Missing the nursing diagnosis section or writing a medical diagnosis instead of a NANDA nursing diagnosis
• Failing to specify CPR parameters (writing 'do compressions' without rate, depth, ratio)
• Checking pulse immediately after a shock instead of resuming compressions
• Not addressing post-ROSC care in the evaluation section

Key Phrases To Include

• scene safety
• simultaneously
• 10 seconds
• agonal gasping
• Decreased Cardiac Output
• NANDA
• Maslow
• physiological survival
• C-A-B
• 100 to 120 per minute
• at least 5 cm
• 30:2
• full recoil
• minimize interruptions
• Code Blue
• AED pad placement
• right subclavian
• left lower lateral
• clear
• immediately resume compressions
• ROSC
• targeted temperature management

Marks

1

Topic

BLS — Priority First Actions

Difficulty

easy

Template Id

T14

Examiner Tip

The examiner is testing the principle that compressions must begin WITHOUT DELAY. Any answer that delays compressions (to find equipment, to call first, to check IV access) loses the mark. Both actions — compress AND activate — must be present.

Model Answer

The first action is to immediately begin high-quality chest compressions while simultaneously calling for help (activating the emergency response system/Code Blue) and directing someone to retrieve the AED.

Question Type

very_short_answer

Answer Structure

• State: begin chest compressions immediately AND activate emergency response (both components needed for full mark) [1 mark]

Scoring Breakdown

Common Mark Deductions

• Starting with airway management before compressions
• Only stating 'call for help' without mentioning compressions
• Starting an IV or preparing drugs before starting compressions

Key Phrases To Include

• immediately begin chest compressions
• activate emergency response
• Code Blue
• AED

Marks

3

Topic

ACLS — CPR Quality Monitoring

Difficulty

hard

Template Id

T15

Examiner Tip

This question rewards students who understand the WHY behind the protocol, not just the rule. ETCO₂ is increasingly tested in NLE ACLS questions — know both its role as a CPR quality monitor and as an early ROSC indicator.

Model Answer

REASON FOR SWITCHING EVERY 2 MINUTES: Fatigue significantly degrades compression quality — specifically, depth and rate decline within 2 minutes of sustained compressions even when the rescuer feels they are maintaining quality. Shallow compressions produce inadequate cardiac output and reduce the chance of survival. By switching compressors every 2 minutes (timed with the rhythm check), the team ensures that compression depth and rate are consistently maintained throughout the resuscitation. The switch should happen as quickly as possible to minimize interruptions in compressions. OBJECTIVE MONITORING WITH END-TIDAL CO₂ (ETCO₂): In ACLS, quantitative end-tidal CO₂ (ETCO₂) monitoring provides real-time, objective feedback on compression quality. ETCO₂ reflects pulmonary blood flow, which is driven by cardiac output from compressions. An ETCO₂ of ≥10 mmHg suggests effective compressions, while a value below this indicates inadequate output. An abrupt sustained rise in ETCO₂ (to ≥35-40 mmHg) without a change in ventilation is an early indicator of Return of Spontaneous Circulation (ROSC), even before a pulse can be confirmed.

Question Type

short_answer

Answer Structure

• Explain physiological rationale for switching (fatigue degrades depth and rate) [1 mark]
• State the frequency (every 2 minutes, timed with rhythm check, minimize interruption time) [1 mark]
• Describe ETCO₂ monitoring: what it measures, target values, ROSC indicator [1 mark]

Scoring Breakdown

Common Mark Deductions

• Giving only the rule (switch every 2 min) without the physiological rationale
• Not explaining what ETCO₂ measures or how it reflects CPR quality
• Confusing ETCO₂ target values or units (e.g., writing '%' instead of 'mmHg')

Key Phrases To Include

• fatigue
• depth and rate decline
• 2 minutes
• rhythm check
• minimize interruption
• end-tidal CO₂
• ETCO₂
• pulmonary blood flow
• cardiac output
• ROSC
• abrupt rise