Compression fraction is the strongest modifiable factor in arrest outcome.
Before you read
Test yourself first: 5 questions
Question 1 of 5
During the resuscitation of a woman in late pregnancy, the uterus is held over toward her left side in order to:
Answer: A. A term uterus lying on the inferior vena cava throttles venous return, and compressions can only move the blood that reaches the heart — shifting it left restores the preload the resuscitation depends on. It is done for hemodynamics, not for access or for positioning, and a resuscitation that skips it can generate technically perfect compressions with very little forward flow.
Question 2 of 5
Midway through a resuscitation, end-tidal CO2 abruptly jumps from 16 to 42 mmHg without any change in compressor. What should the team do next?
Answer: A. A sudden, sustained rise in end-tidal CO2 is often the earliest sign of ROSC as the heart begins moving blood through the lungs, so a pulse and rhythm check is warranted. Treating it as equipment failure or as a ventilation problem risks continuing compressions on a patient who now has circulation.
Question 3 of 5
Why do resuscitation guidelines recommend rotating the compressor about every 2 minutes, ideally during the rhythm check?
Answer: A. Rescuers' depth and recoil deteriorate within a minute or two, often before they feel tired, so planned rotation at the rhythm check keeps compressions effective without adding pauses. The switch should take only a few seconds. Rotation has nothing to do with device charging or legal limits, and the patient never gets a rest period from compressions.
Question 4 of 5
Compressions that are too shallow are harmful because they:
Answer: A. Compression depth is what squeezes blood out of the chest, and a shallow compression moves too little to build the coronary and cerebral perfusion pressure that resuscitation depends on. Shallow compressions do not cause more rib injury — deep ones are the ones associated with it, and that risk is accepted precisely because depth is what works.
Question 5 of 5
Your crew has terminated resuscitation on a patient at home with medical direction. Which action best reflects good care of the family afterward?
Answer: A. Families cope better with clear language such as died or dead, time to ask questions and a provider who stays until support arrives. Euphemisms and false hope create confusion and delay grief. Leaving abruptly or removing the family from the room abandons them at the most difficult moment; follow your agency's direction about equipment and scene preservation.
Keep the streak going with more questions like these, each with a full rationale.
What is cardiology & resuscitation?
The examination theme is that perfusion is generated by compressions and lost by interruptions — nearly every question in the domain reduces to protecting compression fraction or recognizing when the rate itself is the problem.
Key points to remember
- Compression fraction is the strongest modifiable factor in arrest outcome.
- Shockable means VF or pulseless VT; asystole and PEA are not.
- Resume compressions immediately after a shock — do not pause to check a pulse.
- An abrupt ETCO2 rise during CPR suggests return of spontaneous circulation.
Field priorities
- Fit airway, access and rhythm checks around compressions.
- In PEA, hunt the reversible cause while compressions continue.
Coaching the patient
- A stunned myocardium rarely produces a palpable pulse the instant a shock works.
Red flags: act now
- Hypotension or altered mentation with a fast rate
- Inferior ST elevation — check the right side
Cardiology & Resuscitation: FAQs
What are the priority actions for Cardiology & Resuscitation in the field?
Fit airway, access and rhythm checks around compressions. In PEA, hunt the reversible cause while compressions continue.
What findings in Cardiology & Resuscitation change your plan or your transport decision?
Hypotension or altered mentation with a fast rate. Inferior ST elevation — check the right side.
What do I need to know about Cardiology & Resuscitation for the NREMT?
Compression fraction is the strongest modifiable factor in arrest outcome. Shockable means VF or pulseless VT; asystole and PEA are not. Resume compressions immediately after a shock — do not pause to check a pulse. An abrupt ETCO2 rise during CPR suggests return of spontaneous circulation.
What should the crew communicate or document for Cardiology & Resuscitation?
A stunned myocardium rarely produces a palpable pulse the instant a shock works.
