A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm. Which is the appropriate treatment?

• Ventricular Fibrillation (VF) or Pulseless Ventricular Tachycardia (VT):
  • Immediate defibrillation.
  • Follow with CPR if defibrillation is unsuccessful.
  • Administer epinephrine and antiarrhythmic medications as per ACLS guidelines.
• Asystole or Pulseless Electrical Activity (PEA):
  • Begin CPR immediately.
  • Administer epinephrine.
  • Identify and treat reversible causes (H’s and T’s).
• Bradycardia with a pulse (severe, symptomatic):
  • Administer atropine.
  • If atropine is ineffective, consider transcutaneous pacing, dopamine infusion, or epinephrine infusion.
• Supraventricular Tachycardia (SVT) or other narrow complex tachycardias (if causing hemodynamic instability):
  • Synchronized cardioversion.
  • If stable but symptomatic, consider vagal maneuvers or adenosine.

Defibrillation