Advanced Cardiovascular Life Support (ACLS) Practice Exam

A patient with pulseless ventricular tachycardia is defibrillated. What is the next action?

1. Start chest compressions at a rate of at least 100/min

2. Check for a pulse

3. Administer epinephrine

4. Monitor the ECG continuously

The correct answer is: Start chest compressions at a rate of at least 100/min

Defibrillation is employed in the case of pulseless ventricular tachycardia to restore a normal cardiac rhythm. Following defibrillation, the immediate priority is to ensure effective circulation and oxygenation, which is achieved through chest compressions. Initiating high-quality chest compressions at a rate of at least 100 per minute is essential because it helps maintain blood flow to vital organs and supports survival until a normal rhythm can be established. This action is critical as it provides circulatory support during the crucial moments after defibrillation, especially given that the primary aim is to restore a perfusing rhythm. Effective chest compressions are proven to be invaluable in enhancing patient outcomes, especially in the early minutes after a cardiac event. While checking for a pulse might seem logical, it is generally recommended to continue compressions for a short period before reassessing, as pulse checks can interrupt circulation. Furthermore, administering epinephrine or continuous ECG monitoring may be important later in the resuscitation process, but they do not take precedence immediately after defibrillation. Hence, the focus should be on resuming chest compressions promptly.