NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationMedium
A 45-year-old male is found unresponsive, pulseless, and apneic. CPR is initiated immediately by bystanders. An AED is applied and delivers a 'No Shock Advised' message. What is the NEXT most appropriate action for the EMT to take?
- ACheck for a pulse for no more than 10 seconds.
- BAdminister two rescue breaths and reanalyze the rhythm.
- CRemove the AED pads and prepare for transport.
- DResume chest compressions immediately.
Show answer & explanationAnswer & explanation
Correct answer: D. Resume chest compressions immediately.
If an AED advises 'No Shock Advised,' it means the patient's rhythm is either asystole or pulseless electrical activity (PEA), which are not shockable rhythms. The most appropriate action is to immediately resume chest compressions to maintain vital blood flow until advanced life support arrives or the AED reanalyzes.
Why the other options are wrong
- A. Checking for a pulse after a 'No Shock Advised' message is not recommended as it delays compressions. Assume the patient remains pulseless.
- B. While rescue breaths are part of CPR, the immediate priority after any AED analysis (shock or no shock) is to resume chest compressions. Reanalysis occurs after 2 minutes of CPR.
- C. Removing the AED pads would be inappropriate as the AED may re-analyze and advise a shock later, and it provides continuous ECG monitoring.
AED 'No Shock Advised' Protocol
If an AED advises 'No Shock Advised,' immediately resume chest compressions for 2 minutes, as the rhythm is non-shockable (asystole or PEA).
- Minimizing interruptions in CPR is crucial.
- Non-shockable rhythms require continuous high-quality CPR.
- The AED will re-analyze the rhythm after 2 minutes of CPR.
Memory trick: No shock? No problem! Just keep pumping that chest, strong and steady!