Final answer:
After two defibrillation attempts for a patient recovering from a PE, the next step in treatment according to ACLS guidelines is the administration of medications like amiodarone or lidocaine and possibly epinephrine while maintaining high-quality chest compressions at a rate of over 100 compressions per minute.
Step-by-step explanation:
When arriving on a scene with CPR in progress, particularly after a patient recovering from a pulmonary embolism (PE) collapses, it is crucial to follow advanced cardiac life support (ACLS) protocols. After two shocks have been administered, assuming no return of spontaneous circulation (ROSC), and with an established IV in place, the next step would typically involve the use of medication. According to ACLS guidelines, an antiarrhythmic such as amiodarone or lidocaine may be administered to assist in the management of ventricular fibrillation or pulseless ventricular tachycardia, which are common following a PE. It is also possible that the medical team may consider administering an IV dose of epinephrine every 3-5 minutes during the resuscitation effort to improve myocardial and cerebral perfusion.
While continuing these interventions, high-quality chest compressions should be maintained as they are paramount. Compressions should be at least 5 cm deep and at a rate of compressions per minute, to the beat of a familiar tune like 'Staying Alive' by the Bee Gees to help maintain the rhythm. Meanwhile, using the AED is critical if the patient is in cardiac arrest. However, in a hospital setting with nursing staff, it is likely that a manual defibrillator is being used.
Remember, CPR using proper technique between the lines at T4 and T9 on the sternum is performed until the patient regains a pulse or is declared deceased by a qualified healthcare professional. The role of an automated external defibrillator (AED) in public settings cannot be understated, as they are designed to be used even by individuals without medical training, helping save lives by diagnosing cardiac conditions and delivering shocks accordingly.