A 64-year-old patient is found unresponsive. Attaching a heart monitor reveals the rhythm to be ventricular fibrillation. Which drug would the nurse prepare to administer?
• Ventricular fibrillation is a common rhythm in sudden cardiac arrest. Epinephrine (1:10000 solution), although not shown to improve survival, is the only medication recommended for use during cardiac arrest to improve coronary artery perfusion pressure and the rate of ROSC (return of spontaneous circulation). Epinephrine causes cardiac stimulation and vasodilation, increasing heart rate and cardiac output.
• According to the American Heart Association, epinephrine administration should begin following the second shock during resuscitation efforts. The most effective treatment for ventricular fibrillation is rapid defibrillation with a high energy shock.
• Dopamine and dobutamine both increase heart contractility and blood pressure, which is helpful for conditions such as shock, but they are not recommeded during resuscitation attempts involving shockable rhythms.
• Atropine is not recommended during cardiac arrest resulting from ventricular fibrillation.