Refractory VF — DipIMC MCQ

Correct answer: C — Give adrenaline and amiodarone according to the ALS algorithm

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

C is correct: Refractory VF after three shocks is the point at which adrenaline and amiodarone are used in standard adult ALS. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because analgesia is important but does not replace the first physiological intervention; D is less suitable because it does not address the discriminator in the vignette; E is less suitable because it does not address the discriminator in the vignette. 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