NREMT Paramedic Cognitive ExamCardiology & ResuscitationEasy
A 68-year-old male is in cardiac arrest. After 2 minutes of CPR, the rhythm check reveals asystole. The team has established IV access. What is the MOST appropriate next medication to administer?
- ALidocaine 1.5 mg/kg IV.
- BAmiodarone 300 mg IV.
- CEpinephrine 1 mg IV.
- DAtropine 1 mg IV.
Show answer & explanationAnswer & explanation
Correct answer: C. Epinephrine 1 mg IV.
For asystole, epinephrine is the only medication recommended in the ACLS algorithm to improve coronary perfusion pressure and stimulate cardiac activity. Antiarrhythmics like amiodarone or lidocaine are not indicated for asystole.
Why the other options are wrong
- A. Lidocaine is used for VF/pulseless VT, not asystole.
- B. Amiodarone is used for VF/pulseless VT, not asystole.
- D. Atropine is no longer recommended for asystole in current ACLS guidelines.
Asystole Management
Asystole is a 'flatline' rhythm, representing complete absence of electrical activity in the heart. It is a non-shockable rhythm in cardiac arrest.
- Confirm asystole in two leads.
- Continue high-quality CPR.
- Epinephrine is the primary medication.
Memory trick: Asystole is 'Absolutely Empty', so give 'Epinephrine' to 'Energize'!