Advanced Cardiovascular Life Support (ACLS) Practice Exam

What should you do during a pause in CPR if the ECG rhythm shows a non-pulsatile lead II rhythm?

1. Check for signs of circulation

2. Resume compressions

3. Administer a shock immediately

4. Call for more assistance

The correct answer is: Resume compressions

During a pause in CPR, observing a non-pulsatile lead II rhythm on the ECG typically indicates a form of cardiac activity, such as asystole or pulseless electrical activity (PEA), that is not generating effective circulation. In this scenario, it is essential to resume compressions immediately. Continuing chest compressions is crucial because they are the most effective way to provide perfusion to vital organs until definitive treatment can be administered, such as medications or defibrillation, if indicated. Compressions enhance blood flow to the heart and brain, potentially converting the rhythm to one that is more organized, which can improve the chances of recovery. In cases where you see a non-pulsatile rhythm, checking for signs of circulation or calling for assistance would delay the critical intervention that is needed. Administering a shock is not indicated because the rhythms associated with a non-pulsatile blood pressure are not shockable rhythms. Therefore, the most appropriate and impactful action during this pause is to resume compressions without hesitation.