NREMT Paramedic Cognitive ExamCardiology & ResuscitationEasy
A 72-year-old female is found unresponsive, pulseless, and apneic. CPR is immediately initiated. The cardiac monitor shows ventricular fibrillation (VF). What is the MOST appropriate next action?
- AAdminister epinephrine 1 mg IV/IO.
- BCheck for a palpable pulse.
- CDefibrillate immediately with a biphasic device at 200 J.
- DEstablish advanced airway and ventilation.
Show answer & explanationAnswer & explanation
Correct answer: C. Defibrillate immediately with a biphasic device at 200 J.
For a patient in ventricular fibrillation, immediate defibrillation is the most critical intervention to restore a perfusing rhythm. Every minute of delay in defibrillation decreases the chance of survival.
Why the other options are wrong
- A. Epinephrine is given after the first defibrillation and CPR cycle.
- B. A pulse check should be done after 2 minutes of CPR or defibrillation, not before the first shock for VF.
- D. Airway management is important, but defibrillation takes precedence for VF.
Ventricular Fibrillation (VF) Treatment
Ventricular fibrillation is a chaotic, unsynchronized electrical activity in the ventricles leading to no cardiac output. The definitive treatment is immediate defibrillation.
- VF is a shockable rhythm.
- Defibrillation is time-sensitive; delays reduce survival.
- CPR should continue until defibrillator is ready.
Memory trick: VF means 'Zap Fast'!