Sun31October0735PM 2

The cardiac arrest team have been called to the emergency room and you are the designated team leader. An 89-year-old man has been brought in by ambulance in cardiorespiratory arrest.

Chest compressions are on-going. He is intubated and has a cannula in situ. Defibrillator pads are applied to the chest in the pectoro-apical positions.

When the cardiac monitor of the biphasic defibrillator is switched on the rhythm appears to be in fine ventricular fibrillation.

Which is the correct line of management?

(Please select 1 option)

Adrenaline 1 mg 1:10,000 solution

DC cardioversion 200 J

DC cardioversion 150 J

DC cardioversion 360 J Incorrect answer selected

Continue chest compressions This is the correct answer

Explanation

Prior to 2010 the Advance Life Support (ALS) guidance recommended that fine VF be checked by turning up the gain on the monitor and then DC cardioverted. However, current thinking is to continue with cardiorespiratory resuscitation (that is, chest compressions) until the VF develops into coarse VF when it would be appropriate to shock.

The reason for this is the possibility of misinterpretation of fine VF and asystole. Chest compressions are thought to be the mainstay of treatment in cardiac arrest and interruptions should be minimised as much as possible.

Reference:

Resuscitation Council (UK). Adult advanced life support.

Answer Statistics

1

6%

2

28%

3

24%

4

20%

5

24%

Times answered: 287