Refractory ventricular fibrillation — DipIMC MCQ

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EasyResuscitationRefractory ventricular fibrillationDipIMC

A man remains in VF after three shocks with good CPR. IV access is established and the team asks for the next ALS drug. What is the most appropriate drug/dose?

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Correct answer: A — Amiodarone 300 mg IV after the third shock

Option A is correct because Amiodarone 300 mg is given after the third shock for refractory VF or pulseless VT. Option E is less appropriate because that dose is an ALS cardiac-arrest dose and is unsafe for this non-arrest indication; option B is less appropriate because aspirin is useful in ACS but inappropriate for this presentation. Option C is less appropriate because untitrated opioid dosing can cause avoidable hypotension or respiratory depression; option D is less appropriate because steroids have delayed onset and should not replace the immediate treatment. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: Resuscitation Council UK Guidelines