NREMT Paramedic Cognitive ExamCardiology & ResuscitationEasy
A 70-year-old female is found unresponsive and pulseless. CPR is immediately initiated. The cardiac monitor shows disorganized, chaotic electrical activity with no discernible P waves, QRS complexes, or T waves. What is the MOST appropriate next intervention?
- AAdminister epinephrine 1 mg IV
- BDefibrillate immediately with 200 J (biphasic)
- CContinue CPR for 2 minutes
- DAdminister atropine 1 mg IV
Show answer & explanationAnswer & explanation
Correct answer: B. Defibrillate immediately with 200 J (biphasic)
The description of disorganized, chaotic electrical activity with no discernible waves is characteristic of ventricular fibrillation (VF). VF is a shockable rhythm, and immediate defibrillation is the most critical intervention to restore a perfusing rhythm.
Why the other options are wrong
- A. Epinephrine is given after the first defibrillation and subsequent CPR cycle if VF persists, but not as the initial action.
- C. While CPR is ongoing, the priority for VF is to defibrillate as soon as a defibrillator is available.
- D. Atropine is used for symptomatic bradycardia, not VF.
Ventricular Fibrillation (VF) Initial Treatment
Ventricular fibrillation is a chaotic, shockable rhythm requiring immediate defibrillation to attempt to restore normal cardiac activity, in conjunction with high-quality CPR.
- VF is characterized by disorganized electrical activity.
- It is a cause of cardiac arrest and is pulseless.
- Early defibrillation is the most important intervention for survival.
Memory trick: VF = Zap First, Then Push Hard!