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------------------------------------------------ A patient is in cardiac arrest with ventricular fibrillation that has been refractory to the 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

Given the scenario of a patient having ventricular fibrillation resistant to the second shock in cardiac arrest, pinephrine 1 mg IV / IO is usually the first drug administered to restore normal heart functions.

Explanation:

In the scenario you presented, a patient is in cardiac arrest and ventricular fibrillation has proven persistent even after the second defibrillation. In such cases, the first drug traditionally administered is epinephrine 1 mg IV / IO. The aim of using epinephrine in this scenario is to constrict the peripheral blood vessels, enhance heart function and augment the blood flow through the coronary and cerebral arteries. It's noteworthy that while each case is unique and depends on the patient's individual condition, this general guideline holds true in many situations. Options like atropine, lidocaine, and sodium bicarbonate exist, however, these medications are usually administered under specific circumstances or if the primary choice of epinephrine is ineffective.

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