Question

A patient is in cardiac arrest. The cardiac monitor shows asystole. In addition to providing continuous high-quality CPR, what is the other priority intervention for this patient?

Administering epinephrine as early as possible
Inserting an advanced airway
Defibrillating with 360 joules when available
Administering amiodarone as early as possible

Answer 1

In a case of cardiac arrest with asystole, the main intervention besides CPR is the use of an AED, if a shockable rhythm is present. Amiodarone is not indicated for asystole, and CPR should be continued with other ACLS measures like epinephrine administration.

Step-by-step explanation:

When a patient is experiencing a cardiac arrest and the cardiac monitor shows asystole, the priority intervention, in addition to continuous high-quality CPR, is to use an automated external defibrillator (AED) if available. Amiodarone would not be effective in a flatlined heart, because it's an antiarrhythmic medication best used for shockable rhythms like ventricular fibrillation or ventricular tachycardia.

For asystole or a non-pumping heart, the focus is on CPR and potential administration of epinephrine as per Advanced Cardiac Life Support (ACLS) guidelines. The AED analyzes the heart's rhythm and, if a shockable rhythm is detected, delivers an electrical shock in an effort to reset the heart's natural pacemaker and restore a normal rhythm. However, as asystole is a non-shockable rhythm, the AED would not advise a shock and CPR should be continued with any available advanced life support measures.