Registered Cardiovascular Invasive Specialist (RCIS) Practice Test

If a patient in V tach is pulseless and unresponsive, what is the most appropriate action?

1. Administer CPR

2. Perform unsynchronized cardioversion

3. Administer antiarrhythmic medication

4. Call for emergency assistance

The correct answer is: Perform unsynchronized cardioversion

In the scenario where a patient is experiencing pulseless ventricular tachycardia (V tach) and is unresponsive, the most appropriate action is to perform unsynchronized cardioversion. In cases of pulseless V tach, immediate intervention is crucial to restore effective cardiac rhythm. Unmonitored, pulseless V tach is life-threatening and requires prompt and decisive measures to attempt to re-establish a normal rhythm. Synchronized cardioversion is typically used for stable ventricular tachycardia, where the patient has a detectable pulse and is conscious, but in this case, the absence of a pulse indicates that the heart is not effectively pumping blood. While performing CPR is also essential and indeed a critical action in cases of cardiac arrest, it is secondary to attempting to correct the underlying rhythm disturbance through cardioversion in a situation where there is no pulse. Administering antiarrhythmic medication may be appropriate once basic life-support measures have been initiated, but it should not replace the immediate need to restore the heart's function with cardioversion. Calling for emergency assistance is an important step in many medical emergency protocols, but in this specific instance, the swift action of performing unsynchronized cardioversion takes precedence to address the critical