Question

A patient presents with no pulse, and the ECG shows the following rhythm. What is the next appropriate step? 

• A. Defibrillate, check pulse and then perform CPR
• B. Cardioversion
• C. Defibrillate, perform CPR, and then check the pulse
• D. Administer epinephrine

Hint:

In the case of ventricular fibrillation, defibrillation followed by CPR is the most effective initial management to restore circulation and save the patient’s life.

Answer 1

The Correct Option is C

In a case where a patient presents with no pulse, and the ECG shows a rhythm that indicates a shockable cardiac arrest, the immediate goal is to restore circulation. This can often be achieved through defibrillation. Here's the step-by-step solution:

1. Recognize the Situation: The absence of a pulse combined with a shockable rhythm on the ECG (such as ventricular fibrillation or pulseless ventricular tachycardia) indicates the need for immediate intervention.
2. Immediate Action: Defibrillation should be performed as soon as possible. This is critical in the case of shockable rhythms to restore a normal heart rhythm.
3. Perform CPR: After delivering a shock, immediately start Cardiopulmonary Resuscitation (CPR). Continue CPR for two minutes before reassessing the patient.
4. Check the Pulse: After two minutes of CPR, pause to check the patient's pulse and rhythm.

The answer highlighted reflects these crucial steps: "Defibrillate, perform CPR, and then check the pulse."