NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationMedium
A 40-year-old female is in cardiac arrest. CPR is ongoing, and she has been intubated. The cardiac monitor shows asystole. Which medication is MOST appropriate to administer at this point, according to current guidelines?
- AAtropine
- BEpinephrine
- CLidocaine
- DAmiodarone
Show answer & explanationAnswer & explanation
Correct answer: B. Epinephrine
For a patient in cardiac arrest with a non-shockable rhythm like asystole, epinephrine is the primary medication indicated. It is a potent vasoconstrictor and cardiac stimulant that helps improve coronary and cerebral perfusion during CPR.
Why the other options are wrong
- A. Atropine was previously used for asystole/PEA but is no longer recommended in current cardiac arrest guidelines.
- C. Lidocaine is an alternative antiarrhythmic for VF/pulseless VT, not for asystole.
- D. Amiodarone is an antiarrhythmic used for refractory VF/pulseless VT after defibrillation, not for asystole.
Epinephrine in Cardiac Arrest
Epinephrine is a vital medication administered during cardiac arrest to improve myocardial and cerebral blood flow through its alpha-adrenergic effects (vasoconstriction) and beta-adrenergic effects (cardiac stimulation).
- Administered for all non-shockable rhythms (asystole, PEA).
- Administered after initial defibrillation attempts for shockable rhythms (VF/pVT).
- Dose is typically 1 mg IV/IO every 3-5 minutes.
- Improves chances of ROSC (Return of Spontaneous Circulation).
Memory trick: Asystole's flat? Epi's where it's at!