NREMT Paramedic Cognitive ExamOperationsEasy
A paramedic is called to a local park for a 16-year-old male who collapsed during a soccer game. Upon arrival, bystanders are performing CPR. The AED is retrieved and applied, and it advises 'no shock advised'. What is the MOST appropriate next action?
- AContinue CPR for 2 minutes and re-analyze rhythm.
- BDiscontinue CPR and reassess the patient.
- CCheck for a pulse and begin rapid transport.
- DRemove the AED pads and prepare for advanced airway management.
Show answer & explanationAnswer & explanation
Correct answer: A. Continue CPR for 2 minutes and re-analyze rhythm.
If an AED advises 'no shock advised', it means the rhythm is either asystole or a perfusing rhythm. In either case, the most appropriate action is to continue high-quality CPR for 2 minutes before re-analyzing the rhythm, as per AHA guidelines for cardiac arrest.
Why the other options are wrong
- B. Discontinuing CPR without further action is incorrect and harmful; continuous compressions are vital.
- C. Checking for a pulse immediately after 'no shock advised' without continuing CPR is incorrect; CPR should continue for 2 minutes first.
- D. Removing AED pads is inappropriate; the AED should remain attached for continuous monitoring and future analysis.
AED 'No Shock Advised' Protocol
When an AED advises 'no shock advised', it indicates a non-shockable rhythm (asystole or PEA). The immediate next step is to resume or continue high-quality CPR for 2 minutes before re-analyzing the rhythm.
- AED assesses cardiac rhythm.
- 'No shock advised' means non-shockable (asystole or PEA).
- Immediate action: Continue CPR for 2 minutes.
- Re-analyze rhythm after 2 minutes of CPR.
Memory trick: No Shock? Keep Pumping for Two!