Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is the recommended next step after a defibrillation attempt?

1. Begin CPR, starting with chest compressions

2. Check the patient's pulse

3. Administer a second shock immediately

4. Provide oxygen to the patient

The correct answer is: Begin CPR, starting with chest compressions

After a defibrillation attempt, the recommended next step is to begin CPR, starting with chest compressions. This is a critical part of the post-defibrillation protocol because if the defibrillation is unsuccessful in restoring a normal heart rhythm, immediate CPR helps maintain blood flow to vital organs. High-quality chest compressions are essential in maximizing the chances of survival, as they can help keep the brain and heart alive until a more stable rhythm can be restored either through a second defibrillation attempt or advanced medical intervention. The rationale for not checking the patient's pulse immediately after defibrillation is twofold: first, it can be time-consuming and may delay the initiation of lifesaving CPR, and second, accurate pulse checks can be difficult in an emergency scenario where the patient's condition is uncertain. Additionally, administering a second shock right away is not advised; the usual protocol includes a brief period for effective CPR (usually about two minutes) before considering another shock, allowing time for any electrical activity to possibly stabilize. Providing oxygen is important, but it should occur in conjunction with CPR efforts rather than as a standalone immediate action. Thus, starting CPR immediately optimizes the chances of improving the patient's outcome.