A 39-year-old man in asystole has been unresponsive to high-quality CPR and two doses of epinephrine. The patient is intubated and an IO catheter is in place. You should focus on:

CARDIOLOGY

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Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]

A	establishing a peripheral IV line.
B	providing mild hyperventilation.
C	searching for reversible causes
D	transcutaneous cardiac pacing.

Explanation:

Detailed explanation-1: -High-quality CPR is the mainstay of treatment and the most important predictor of a favorable outcome. Asystole is a non-shockable rhythm.

Detailed explanation-2: -The only two drugs recommended or acceptable by the American Heart Association (AHA) for adults in asystole are epinephrine and vasopressin. Atropine is no longer recommended for young children and infants since 2005, and for adults since 2010 for pulseless electrical activity (PEA) and asystole.

Detailed explanation-3: -CPR is considered the primary method of immediately treating a person in asystole. Unlike VFib or ventricular tachycardia, which can be treated by shocking a person with a defibrillator, asystole is considered a “nonshockable” rhythm. However, effective CPR may convert asystole into a shockable rhythm.

Detailed explanation-4: -When an advanced airway (ie, endotracheal tube, Combitube, or LMA) is in place during 2-person CPR, ventilate at a rate of 8 to 10 breaths per minute without attempting to synchronize breaths between compressions. There should be no pause in chest compressions for delivery of ventilations (Class IIa).

There is 1 question to complete.

CLINICAL MEDICINE

MEDICINE

CARDIOLOGY