Advanced Cardiovascular Life Support (ACLS) Practice Exam

After 2 minutes of CPR, the ECG shows PEA and the patient has no pulse. What is the next priority step?

1. Administer 1mg of epinephrine

2. Resume chest compressions

3. Intubate the patient

4. Monitor the ECG for 2 minutes

The correct answer is: Administer 1mg of epinephrine

In the scenario where the ECG shows pulseless electrical activity (PEA) after 2 minutes of CPR and the patient has no pulse, the most critical next step is to administer 1mg of epinephrine. Epinephrine is a powerful vasoconstrictor that enhances coronary and cerebral perfusion during cardiopulmonary resuscitation (CPR). It is a key medication used in the management of cardiac arrest and is aimed at increasing the chances of restoring effective circulation. PEA indicates that there is electrical activity within the heart, but it is not resulting in an adequate mechanical contraction, hence the absence of a pulse. By administering epinephrine, you potentially improve the blood flow to the heart and vital organs, increasing the likelihood of the heart starting to pump effectively again. This administration is typically recommended as soon as possible in advanced cardiac life support (ACLS) protocols. The other options, while they may play a role at different stages of resuscitation, are not priorities at this exact moment. For instance, resuming chest compressions is crucial but needs to happen in conjunction with medications like epinephrine. Intubation, while important for securing the airway, does not take immediate precedence in the context of a