A patient presents to the emergency department (ED) with acuteonset chest pain radiating to his jaw and down his left arm. During evaluation he becomes unresponsive and pulseless. His ECG demonstrated wide complex tachycardia.
Which of the following answer choices is most correct regarding the underlying rhythm and coinciding appropriate treatment for this patient?
A. Pulseless electrical activity (PEA), synchronized cardioversion with biphasic 120 JCorrect Answer: E
A successful resuscitation effort is determined by high-quality CPR in addition to timely defibrillation, if amenable. Recognizing the difference between shockable and nonshockable rhythms is key to resuscitation efforts. The patient in this question has pulseless ventricular tachycardia, which should be treated with biphasic unsynchronized cardioversion starting at 120 J. This cardioversion continues during the process of advanced cardiac life support (ACLS) until ROSC occurs or the patient becomes asystolic or develops PEA. If using a monophasic defibrillator, then a single unsynchronized 360-Joule dose should be administered.
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