Advanced Cardiovascular Life Support (ACLS) Practice Exam

After completing your first 2-minute period of CPR, you see an organized, nonshockable rhythm on the ECG monitor. What should you do next?

1. Check the blood pressure

2. Have a team member attempt to palpate a carotid pulse

3. Prepare for possible intubation

4. Administer IV fluids

The correct answer is: Have a team member attempt to palpate a carotid pulse

When an organized, nonshockable rhythm is observed on the ECG monitor after a 2-minute period of CPR, the next important step is to confirm the restoration of circulation. Having a team member attempt to palpate a carotid pulse serves this purpose. If a pulse is present, it indicates that the heart is generating effective circulation, which is crucial information for the team as it dictates the subsequent treatment steps. Checking blood pressure might not be immediately practical or effective in the context of resuscitation efforts, as the patient may still be in a fragile state even if a pulse is detected. Preparing for intubation and administering IV fluids may not be the next immediate priorities unless the situation dictates otherwise, such as in a case of respiratory failure or ongoing hypovolemia, respectively. The primary focus after observing an organized rhythm is to assess circulation through pulse palpation.