vf - cd45

[ArchivalUser]

you are asked to evaluate a 65 yr old man in the ER complainig of acute onset chest pain. during ur evaluation th ept becomes unresponsive and pulseless. EKG shows vetricular fibrillation. what is the most appropriate sequence of events

a. immediately begin CPR, followed by intubation, folowed by defibrillation starting at 100J, then 200J then 360 J

b. immediately begin CPR, followed by intubation, folowed by defibrillation starting at 200J, then 300J then 360 J

c. immediately begin CPR, folowed by defibrillation starting at 100J, then 200J then 360 J

d. immediately begin CPR, folowed by defibrillation starting at 200J, then 300J then 360 J

e. immediately begin CPR, folowed by defibrillation at 200 J, then intubate

[ArchivalUser]

C. No need to intubate a patient who is pulseless.

[ArchivalUser]

no try again

despite efforts outlined in the above answer patient has persistent VF. the use of which drug is most appropriate in sequence...(be careful this is tricky)
a. lidocaine
b. amiodarone
c. prpacainamide
d. epinephrine
e. bretylium

[ArchivalUser]

pt in the above question ultimately develops sinus rhythm with stable BP. he is transferred to the ICU. it is determined that the eitilogy of his VF is asso with a large ant wall MI. during post infarction recovery state the pt udergoes PTCA and stent placement. the pt has no further chest pain and no further arrythmias during hospitalization. what is the most appropriate MX decision wrt his arrythmia.
a. no antiarrythmic required
b. an implantable cardioverter defibrillator
c. beta blocker
d. amiodarone
e. flecainide

[ArchivalUser]

1. B
2. D
3. C but not sure? r/o D b/c Pt is stable & in sinus rhtym

Initially do -> ABCD incl Defib 3 x
no Response -> Epi then defib again
No Response -> Cardio versive Drugs (like Amio/Procain/Lidoc)

[ArchivalUser]

cd45

thanks for posting good Qs, please give us the final anwser and explanation

[ArchivalUser]

1 D
2 D (epineph)
3 C

[ArchivalUser]

yes
d
d
c

[ArchivalUser]

can anyone pls elborate on why we do not Intubate 1st and
in what situation we would have Intubated the Pt.


Thanks

[ArchivalUser]

ans D/ epi/ amidarone

cd45 watz d ans plz