ACLS Megacode 7 Out-of-Hospital

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Step 1 of 9

You are a healthcare provider working as part of an ALS-equipped medical team at a major sports venue. During a collegial basketball game, a security officer requests medical assistance for a 47-year-old female spectator that appears to be experiencing a syncopal episode. You and another team member arrive at their location in the stadium within 2 min, at which point the spectator has regained consciousness, but is now feeling nauseated and complaining of generalized weakness. A rapid initial assessment reveals the following:

Vital signs
  • Pulse rate: 38/min
  • Blood pressure: 81/52
  • Respiratory rate: 16/min
  • Temperature: 38.2 °C
Physiological systems
  • Integumentary: Pale, dry
  • Cardiovascular: Palpable peripheral pulses bilaterally
  • Respiratory: Lungs CTA bilaterally
  • Neurological: Alert, oriented
1. A cardiac monitor is attached to the patient. A rhythm check reveals a second-degree atrioventricular block at 38/min. You provide the patient with supplemental oxygen via NC while your partner establishes IV access. What are your initial actions?*