After identifying a shockable rhythm, what is the recommended sequence?

After identifying a shockable rhythm, what is the recommended sequence?

• A. Deliver shock, wait for ROSC, then CPR
• B. Deliver shock, resume CPR for 2 minutes, then administer epinephrine 1 mg IV/IO every 3-5 minutes and deliver subsequent shocks as indicated
• C. Deliver shock, then immediately give amiodarone
• D. CPR for 5 minutes before shocking

Answer: (B)

When a shockable rhythm is identified in cardiac arrest, the priority is to restore perfusion while defibrillating. The best sequence is to deliver the shock, then immediately resume CPR for about 2 minutes to maintain blood flow to the brain and heart. During that CPR period, give epinephrine 1 mg IV/IO every 3-5 minutes to improve perfusion pressures, and perform subsequent shocks as indicated by rhythm checks. Amiodarone is used if VF/pVT persists after several shocks, not right after the first one. Delaying CPR, delaying defibrillation, or waiting excessively before giving meds would reduce the chances of ROSC and survival.

When a shockable rhythm is identified in cardiac arrest, the priority is to restore perfusion while defibrillating. The best sequence is to deliver the shock, then immediately resume CPR for about 2 minutes to maintain blood flow to the brain and heart. During that CPR period, give epinephrine 1 mg IV/IO every 3-5 minutes to improve perfusion pressures, and perform subsequent shocks as indicated by rhythm checks. Amiodarone is used if VF/pVT persists after several shocks, not right after the first one. Delaying CPR, delaying defibrillation, or waiting excessively before giving meds would reduce the chances of ROSC and survival.