A previously healthy individual collapses while walking through the hospital cafeteria. Medical staff rapidly confirm the absence of a central pulse and normal breathing. A crash cart is brought to the scene, and the cardiac monitor displays coarse ventricular fibrillation. Arrange the following subsequent interventions in the correct chronological order according to standard Advanced Cardiovascular Life Support (ACLS) protocols for this specific presentation.
- 1Initiate continuous chest compressions while the defibrillator is being attached and charged
- 2Deliver a high-energy unsynchronized defibrillation shock
- 3Immediately resume chest compressions for 2 minutes without pausing for a rhythm check
- 4Administer 1 mg of intravenous epinephrine during a subsequent CPR cycle
- 5Administer intravenous amiodarone for refractory ventricular fibrillation
Cevap
The correct chronological sequence is to initiate CPR immediately, deliver the first defibrillation shock, resume CPR instantly for 2 minutes without checking the rhythm, administer epinephrine if subsequent shocks are needed, and finally administer amiodarone if the ventricular fibrillation proves refractory.
The established ACLS pathway for shockable rhythms (VF/pVT) demands continuous CPR while equipment is readied, followed by a defibrillation attempt. Critically, high-quality chest compressions must be restarted immediately after the shock without pausing to check the monitor or pulse. Pharmacotherapy is introduced later in the algorithm: epinephrine is given if the patient remains in a shockable rhythm after the second shock, and amiodarone is reserved for refractory cases surviving past a third shock.
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Advanced Cardiovascular Life Support (ACLS) Ventricular Fibrillation Algorithm
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