A 58-year-old collapses in the ICU. CPR is in progress. The monitor shows a narrow-complex organized rhythm at 70/min with no pulse. Epinephrine 1 mg has been given. Which statement BEST guides the next 2 minutes of care?
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AContinue high-quality CPR, search for and treat reversible causes of PEA, and reassess rhythm and pulse after 2 minutes.
BAdminister atropine 1 mg IV because the rate of 70/min represents relative bradycardia in PEA.
CCease compressions briefly to allow the organized rhythm to generate a pulse spontaneously.
DAttempt synchronized cardioversion at 200 J because the organized rhythm may respond to electrical therapy.
✓ Correct answer: A. Continue high-quality CPR, search for and treat reversible causes of PEA, and reassess rhythm and pulse after 2 minutes.Pulseless electrical activity (PEA) is treated with uninterrupted high-quality CPR, epinephrine every 3-5 minutes, and aggressive search for the 6 Hs and 6 Ts; atropine is not indicated for PEA and cardioversion has no role.
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