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Ventricular fibrillation drug timing — DIPIMC MCQ

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ModerateResuscitationVentricular fibrillation drug timingDIPIMCDipIMC

You are leading the resuscitation of an adult in out-of-hospital cardiac arrest. The initial rhythm is ventricular fibrillation, and two shocks have already been delivered with high-quality compressions throughout. Intravenous access is established. At what point should adrenaline and amiodarone first be given?

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Correct answer: B — Adrenaline 1 mg and amiodarone 300 mg after the third shock

In a shockable rhythm, adrenaline 1 mg is given after the third shock and then every 3-5 minutes, and amiodarone 300 mg is also given after the third shock. Giving adrenaline immediately is the approach for non-shockable rhythms, where it is administered as soon as access is available, not for ventricular fibrillation. Amiodarone is not given before shocks. Pearl: a further 150 mg of amiodarone may follow after the fifth shock in refractory ventricular fibrillation.

Reference: Resuscitation Council UK Guidelines 2025 (Adult Advanced Life Support)