Refractory VF drug — DipIMC MCQ

Correct answer: C — Adrenaline 1 mg and amiodarone 300 mg

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

A is correct: Adult refractory VF after three shocks is treated with adrenaline 1 mg and amiodarone 300 mg as part of ALS. B is less suitable because analgesia is important but does not replace the first physiological intervention; C is less suitable because this is not a definitive treatment for the condition described; D is less suitable because the dose is below standard severe adult asthma nebuliser dosing; E is less suitable because a large initial opioid bolus risks hypotension and respiratory depression. 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