What is the recommended sequence for ventricular fibrillation treatment?

What is the recommended sequence for ventricular fibrillation treatment?

• A. CPR, defibrillate (360 joules) and repeat, epinephrine, amiodarone
• B. Defibrillate, then CPR
• C. Pacemaker
• D. Observation

Answer: (A)

Ventricular fibrillation is a shockable cardiac arrest rhythm, so the priority is to terminate the chaotic electrical activity with a defibrillating shock while maintaining perfusion through chest compressions. The sequence shown emphasizes delivering chest compressions to keep blood flowing, then giving a defibrillating shock (at the standard 360 joules for a biphasic device) and repeating shocks as needed to restore an organized rhythm. After the initial defibrillation attempts, vasopressor support with epinephrine is given to improve coronary and cerebral perfusion and increase the likelihood of return of spontaneous circulation. If VF persists after shocks, an antiarrhythmic such as amiodarone is used to stabilize the heart and reduce further episodes. Other options—pacing a rhythm that isn’t shockable, or simply observing—do not address the urgent need to stop VF with defibrillation and support perfusion and rhythm with drugs.

Ventricular fibrillation is a shockable cardiac arrest rhythm, so the priority is to terminate the chaotic electrical activity with a defibrillating shock while maintaining perfusion through chest compressions. The sequence shown emphasizes delivering chest compressions to keep blood flowing, then giving a defibrillating shock (at the standard 360 joules for a biphasic device) and repeating shocks as needed to restore an organized rhythm. After the initial defibrillation attempts, vasopressor support with epinephrine is given to improve coronary and cerebral perfusion and increase the likelihood of return of spontaneous circulation. If VF persists after shocks, an antiarrhythmic such as amiodarone is used to stabilize the heart and reduce further episodes. Other options—pacing a rhythm that isn’t shockable, or simply observing—do not address the urgent need to stop VF with defibrillation and support perfusion and rhythm with drugs.