Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is the most appropriate intervention for a rapidly deteriorating patient with unstable ECG findings?

1. Administer antiarrhythmic drugs

2. Initiate CPR

3. Synchronized cardioversion

4. Observe for a few minutes

The correct answer is: Synchronized cardioversion

The most appropriate intervention for a rapidly deteriorating patient with unstable ECG findings is synchronized cardioversion. This procedure is crucial in situations where a patient exhibits unstable tachyarrhythmias, such as narrow or wide complex tachycardia, that can lead to deterioration in hemodynamic status. When a patient is unstable, it typically indicates that their blood pressure is low, they may be experiencing symptoms like chest pain, altered mental status, or other signs of inadequate perfusion. Synchronized cardioversion provides immediate corrective therapy by delivering a controlled electrical shock that is timed with the patient's R wave, effectively restoring a normal rhythm without causing further damage to the heart. This can be especially important in conditions like atrial fibrillation with rapid ventricular response or ventricular tachycardia when the patient is experiencing symptoms of instability. Other interventions, such as administering antiarrhythmic drugs, may take longer to achieve a therapeutic effect and might not be suitable for a rapidly unstable patient. Initiating CPR is critical for cardiac arrest situations but is not the primary response to an unstable patient who still is conscious; however, it might become necessary if the patient loses consciousness. Observing for a few minutes is not appropriate in a rapidly deteriorating situation, as timely