A patient is in cardiac arrest, and ventricular fibrillation has been refractory to a second shock. Which drug should be administered first?

A. Atropine 1 mg IV/IO
B. Epinephrine 1 mg IV/IO
C. Lidocaine 1 mg/kg IV/IO
D. Sodium bicarbonate 50 mEq IV/IO

Answer :

Final answer:

In a cardiac arrest scenario with refractory ventricular fibrillation, the first-line drug to administer is Epinephrine 1 mg IV/IO, as it enhances the chance for return of spontaneous circulation. Although Atropine, Lidocaine, and Sodium bicarbonate can also be used in cardiac arrest, they are not first-line drugs for ventricular fibrillation.

Explanation:

The subject of your question pertains to the correct emergency pharmacological management for a patient in cardiac arrest experiencing refractory ventricular fibrillation. In this scenario, the recommended first-line drug to administer is Epinephrine 1 mg IV/IO. Epinephrine increases peripheral vascular resistance and coronary perfusion during CPR and has been shown to enhance the chance for return of spontaneous circulation (ROSC).

Ventricular fibrillation is a type of cardiac arrhythmia characterized by uncoordinated contraction of the cardiac muscle of the ventricles in the heart, making them quiver rather than contract properly. This severely interferes with the heart's ability to pump blood, and is a medical emergency that requires immediate intervention. The mainstay of treatment is immediate defibrillation, but pharmacological support is crucial adjunctive therapy.

Atropine, Lidocaine, and Sodium bicarbonate may also have a role in managing cardiac arrest, but they are not typically first-line choices for a patient presenting with ventricular fibrillation. Utilization of these drugs typically follow more specific case considerations and guidelines.

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