Advanced Cardiovascular Life Support (ACLS) Practice Exam

After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. What is your next action?

1. Prepare for intubation

2. IV or IO access

3. Administer epinephrine

4. Check for a pulse again

The correct answer is: IV or IO access

After verifying the absence of a pulse and initiating CPR with adequate bag-mask ventilation, the critical next action is to establish IV (intravenous) or IO (intraosseous) access. This step is vital because it allows for the rapid administration of medications such as epinephrine and other necessary interventions, which are crucial for improving the patient's chances of survival during cardiac arrest. Establishing IV or IO access enables healthcare providers to deliver lifesaving drugs effectively and efficiently, especially in a resuscitation scenario where every second counts. The ACLS guidelines emphasize the importance of obtaining vascular access early in the resuscitation efforts as medications need to be administered to facilitate heart rhythm stabilization and enhance perfusion. While preparing for intubation is important in advanced airway management, it typically follows the establishment of IV access and the administration of medications. Administering epinephrine is a critical step as well, but it should be done after confirming that IV or IO access is in place. Checking for a pulse again is also essential, but in the immediate steps of resuscitation, establishing access to deliver medications takes precedence.