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Answer :
Final answer:
The correct option is (D). In cases of refractory ventricular fibrillation during CPR, after the initial administration of epinephrine and an antiarrhythmic, a subsequent dose of epinephrine 1 mg should be given. Sodium bicarbonate is used for different indications and higher epinephrine doses are not standard protocol.
Explanation:
In the scenario where a patient is experiencing refractory ventricular fibrillation, after high-quality CPR and administration of epinephrine and an antiarrhythmic drug, the next step according to Advanced Cardiac Life Support (ACLS) guidelines is to administer additional doses of medication.
After the first dose of epinephrine following the second shock and the administration of an antiarrhythmic after the third shock, the appropriate order would typically be another dose of epinephrine 1 mg, which should be given every 3 to 5 minutes during cardiac arrest.
Sodium bicarbonate is generally reserved for specific situations such as hyperkalemia or overdose of certain drugs, and high doses of epinephrine are not standard in ACLS protocols. The second dose of antiarrhythmic might be considered after additional defibrillation attempts depending on the specific circumstance and ACLS guidelines. The correct option is (D).
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Final answer:
Correct option is D. Epi 1 mg. In the scenario of refractory ventricular fibrillation with CPR in progress, the team leader should generally order a 1 mg dose of epinephrine according to ACLS guidelines.
Explanation:
If a patient is in refractory ventricular fibrillation and high-quality CPR is in progress with one dose of epinephrine given after the second shock and an antiarrhythmic drug given after the third shock, as a team leader, you should generally order Epi 1 mg. This is based on Advanced Cardiac Life Support (ACLS) protocols that suggest administration of epinephrine every 3-5 minutes during cardiac arrest. It is essential to follow the guidelines and algorithms provided by the ACLS when managing a patient in cardiac arrest due to ventricular fibrillation.
