Ventricular Fibrillation

You are at the gym and witness a 16-year-old on the treadmill slump to the ground.

You rush to assess the person and find them to be pulseless and not breathing.

You continue CPR. A bystander runs to find an AED. A second bystander arrives to help.

You continue CPR. EMS arrives and has a defibrillator.

The patient remains unresponsive and pulseless. The initial rhythm on the monitor demonstrates the following:

You would like to attempt defibrillation. The EMS providers ask how many Joules you would like delivered.

You defibrillate at 2 J/kg and continue CPR.

After a round of CPR, patient remains pulseless with persisting ventricular fibrillation on the monitor. You defibrillate a second time and continue CPR.

Despite resuscitative efforts, patient remains unresponsive and pulseless.

On reassessment, the monitor demonstrates the following:

You continue your resuscitative efforts. After defibrillation and CPR, you re-assess the patient.

The monitor remains unchanged:

However, you can palpate a faint pulse and paramedics report BP of 70/40. You continue manually bagging the patient. IVF’s are being administered.