Florida State Paramedic Practice Exam

What is the next process to follow after administering three stacked shocks and finding no pulse in a patient in Vfib?

1. CPR, Epi, shock, Lidocaine

2. Immediate intubation

3. Administer adenosine

4. Transport to hospital

The correct answer is: CPR, Epi, shock, Lidocaine

After administering three stacked shocks to a patient in ventricular fibrillation (Vfib) and determining that there is no pulse, the next appropriate step is to initiate high-quality cardiopulmonary resuscitation (CPR). The primary goal at this point is to provide circulation to vital organs until more advanced interventions can be implemented. Following CPR, the administration of epinephrine is recommended. Epinephrine helps to improve perfusion pressure during CPR and supports the likelihood of successful defibrillation in cases of cardiac arrest. After the administration of epinephrine, another shock can be delivered. The mention of Lidocaine is relevant in certain cases for managing ventricular arrhythmias, but its routine use in post-defibrillation care in Vfib scenarios is not standard practice, especially as newer guidelines favor the use of amiodarone instead. Nonetheless, its inclusion in the answer choice is representative of medications that may be considered in specific contexts after the initial shock and resuscitation efforts. Immediate intubation (the second choice) may be necessary later on depending on the patient's airway status, but it is not the immediate next step in managing Vfib arrest. Administering adenosine (the third choice) is inappropriate in this scenario, as