Advanced Cardiovascular Life Support (ACLS) Practice Exam

After completing 2 minutes of CPR on a patient with a non-pulsatile rhythm, what is the next management step?

1. Administer 1mg of epinephrine

2. Reassess the airway

3. Intubate the patient

4. Continue CPR for another 2 minutes

The correct answer is: Administer 1mg of epinephrine

After completing 2 minutes of CPR on a patient with a non-pulsatile rhythm, the appropriate next step in management is to administer epinephrine. This is essential because, during cardiac arrest, the early administration of epinephrine enhances perfusion and can potentially increase the chances of return of spontaneous circulation (ROSC). Epinephrine acts as a potent vasoconstrictor, which improves coronary and cerebral perfusion pressure during compressions. In the context of the other options, while reassessing the airway and potentially intubating the patient are important aspects of airway management in advanced resuscitation, they should not take precedence over the immediate need for continued effective CPR and medication administration. Focusing on rapid interventions such as drug administration following CPR optimizes outcomes in advanced cardiac life support. Additionally, continuing CPR for another 2 minutes without administering epinephrine does not align with current guidelines, which recommend providing adjunctive medications regularly during cardiac arrest management to support the likelihood of successful resuscitation efforts.