Soru

Paramedics transport an $82$-year-old female to the acute care area following a syncopal episode at her residence. Her family reports she complained of severe dizziness and chest heaviness immediately before losing consciousness. Her medical history is significant for hypertension, hyperlipidemia, and a myocardial infarction three years ago. Upon arrival, the patient is lethargic and profoundly diaphoretic. Vital signs show a temperature of $36.4^\circ\text{C}$ ($97.5^\circ\text{F}$), blood pressure of $72/40\text{ mmHg}$, pulse of $28/\text{min}$, and respiratory rate of $18/\text{min}$. Oxygen saturation is $94\%$ on room air. Physical examination reveals cool, clammy extremities with a capillary refill time of $4\text{ seconds}$. Jugular venous distention is absent, and lung fields are clear to auscultation bilaterally. A $12$-lead electrocardiogram displays regular P waves at a rate of $90/\text{min}$ and regular, broad QRS complexes ($0.16\text{ sec}$) at a rate of $28/\text{min}$ with complete dissociation between the atria and ventricles. Two large-bore intravenous lines are secured. Which of the following is the most appropriate next step in the stabilization of this patient?