Question

A patient was in refractory vfib; the rhythm shown here is on the cardiac monitor. A 3rd shock has just been administered. Your team looks to you for instructions. What is your next action?

Answer 1

Following a 3rd shock for a patient in refractory ventricular fibrillation, immediately resume CPR for 2 minutes, then reassess. If vfib continues, administer appropriate medications and consider additional defibrillator shocks, always pairing with effective CPR as per ACLS guidelines.

Step-by-step explanation:

After administering a 3rd shock to a patient in refractory ventricular fibrillation (vfib), it's important to continue following the Advanced Cardiac Life Support (ACLS) protocol. Immediately resume CPR for 2 minutes (5 cycles of 30:2 compressions to breaths ratio) before reassessing the heart rhythm and pulse. If the vfib persists, the next steps include administering medication such as epinephrine or antiarrhythmic drugs like amiodarone or lidocaine, based on the recommendations of ACLS guidelines. The individual may also require additional defibrillator shocks with increased energy levels.

It is crucial to continue CPR between defibrillator shocks and after medication administration to sustain blood flow to the heart and brain. Defibrillation attempts are more successful when coupled with effective CPR. The use of an Automated External Defibrillator (AED) or manual defibrillator aids in delivering controlled electric shocks to reestablish a normal sinus rhythm.