Question

A pt is in refractory V fib. CRP is in progess. One dose of epinephrine was given after the second shock. An antiarrhythimic drug was given immediate after the thirst shock. You are the team leader. Which med do you order next?

A. Epinephrine 1 mg
B. epinephrine 3 mg
C. Sodium bicarbonate 50 mEq
D. a second dose of the antiarrhythmic drug

Answer 1

For a patient in refractory V fib after initial interventions, the next step is to give another dose of epinephrine 1 mg IV/IO every 3-5 minutes during CPR as per ACLS protocols.

Step-by-step explanation:

In the scenario where a patient is in refractory V fib and CPR is in progress with one dose of epinephrine already administered after the second shock, and an antiarrhythmic drug post the third shock, the next step involves reassessment and following ACLS (Advanced Cardiac Life Support) protocols. According to these guidelines, if a patient remains in refractory V fib after initial defibrillation attempts, CPR, and administration of epinephrine and an antiarrhythmic, a repeated dose of epinephrine 1 mg IV/IO should be given every 3-5 minutes during the resuscitation effort. A second dose of an antiarrhythmic can be considered if V fib persists, but it usually follows the administration of the second dose of epinephrine.