Asystolic arrest — DipIMC MCQ

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ModerateResuscitationAsystolic arrestDipIMC

A 74-year-old is found unresponsive at home. High-quality CPR is in progress, pads show asystole in two leads and no reversible cause is yet apparent. What is the most appropriate immediate action?

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Correct answer: B — Continue CPR and give adrenaline 1 mg intravenously or intraosseously

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

E is correct: In non-shockable adult arrest, adrenaline is given as soon as vascular access is available while CPR continues. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because it does not address the discriminator in the vignette; C is less suitable because a detailed survey is inappropriate before correcting an immediate threat; D is less suitable because it creates avoidable delay in a time-critical presentation. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: Resuscitation Council UK Guidelines 2025; JRCALC Guidelines