Repeated Medical PG Question- 22

#MEDICINE( INi-CET)

Q- What would be the first line of treatment is a patient who develops the condition as represented in the picture below after intravenous injection of potassium chloride?

      A. I.V Atropine.

      B. I.V Adrenaline

      C. Defibrillation

      D. IPPV

Answer is C

The condition shown in the picture above represents ventricular fibrillation.

Ventricular fibrillation (VF)

• It is a life-threatening cardiac arrhythmia in which the coordinated contraction of the ventricular myocardium is replaced by high-frequency, disorganized excitation, resulting in failure of the heart to pump blood

• VF is the most commonly identified arrhythmia in cardiac arrest patients.

Treatment:

• Initiate CPR by giving 30 chest compressions, then open the airway and deliver 2 breaths. Continue CPR in this compression-to-ventilation ratio (30:2) until the AED/defibrillator arrives and is set up.

• External electrical defibrillation remains the most successful treatment for VF.

• Defibrillation should be carried out immediately (as early as possible), even before intubation or insertion of an intravenous device.

• Immediate Defibrillation is the resuscitative measure of choice in all patients in cardiac arrest due to ventricular fibrillation on ventricular tachycardia (Shockable Rhythms) irrespective of the cause.

• Vasopressors (epinephrine or vasopressin) are given per the asystole/pulseless electrical activity ACLS algorithm:

• Antiarrhythmic agents can be given before or after the shock.

• Amiodarone or lidocaine

• If torsade de pointes is present, consider magnesium sulfate.