What is the basic ACLS sequence for a patient in cardiac arrest with a shockable rhythm?

What is the basic ACLS sequence for a patient in cardiac arrest with a shockable rhythm?

• A. Call code, deliver shock, then resume CPR and administer medications per protocol
• B. Start CPR, call code, deliver shock as indicated, resume CPR, administer epinephrine and amiodarone per protocol
• C. Start CPR, call code, deliver shock only and no medications
• D. Administer epinephrine before CPR

Answer: (C)

In a shockable arrest, the priority is to keep blood flowing with high-quality CPR while getting the defibrillator ready and delivering a shock as soon as it’s advised. Defibrillation is the definitive treatment for VT/VF, so you don’t want to delay it to give medications. After the shock is delivered, you immediately resume CPR and continue in cycles, while the team calls for help and prepares to give essential drugs (epinephrine and an antiarrhythmic such as amiodarone) at the recommended intervals per protocol. This approach—start CPR right away, call for help, deliver the shock when indicated, then resume CPR and administer medications according to protocol—provides the best chance of restoring a perfusing rhythm and preserving neurological function. Delaying CPR to give meds first, or performing CPR and then skipping medications, or administering epinephrine before starting CPR, do not fit the ACLS sequence for a shockable rhythm because they either delay the critical perfusion provided by CPR or omit beneficial medications from the ongoing resuscitation.

In a shockable arrest, the priority is to keep blood flowing with high-quality CPR while getting the defibrillator ready and delivering a shock as soon as it’s advised. Defibrillation is the definitive treatment for VT/VF, so you don’t want to delay it to give medications. After the shock is delivered, you immediately resume CPR and continue in cycles, while the team calls for help and prepares to give essential drugs (epinephrine and an antiarrhythmic such as amiodarone) at the recommended intervals per protocol. This approach—start CPR right away, call for help, deliver the shock when indicated, then resume CPR and administer medications according to protocol—provides the best chance of restoring a perfusing rhythm and preserving neurological function.

Delaying CPR to give meds first, or performing CPR and then skipping medications, or administering epinephrine before starting CPR, do not fit the ACLS sequence for a shockable rhythm because they either delay the critical perfusion provided by CPR or omit beneficial medications from the ongoing resuscitation.