Final answer:
As a team leader during a refractory ventricular fibrillation case, after initial interventions of CPR, epinephrine, and an antiarrhythmic, you should administer another antiarrhythmic dose in line with ACLS guidelines.
Step-by-step explanation:
In a case of refractory ventricular fibrillation where CPR is in progress and one dose of epinephrine has been administered followed by an antiarrhythmic drug after the third shock, as a team leader, you should consider ordering another antiarrhythmic if the initial one was amiodarone or to consider an alternative like lidocaine if it wasn't used first. Defibrillation attempts should continue in conjunction with medication administration as per Advanced Cardiac Life Support (ACLS) guidelines.