In ventricular tachycardia without a pulse, which intervention is the standard immediate action?

In ventricular tachycardia without a pulse, which intervention is the standard immediate action?

• A. Synchronized cardioversion
• B. Amiodarone infusion
• C. Vagal maneuvers
• D. Defibrillate (unsynchronized) + CPR

Answer: (D)

Pulseless ventricular tachycardia is a shockable arrest rhythm, so the immediate priority is to deliver an unsynchronized defibrillation to depolarize the heart and reset the rhythm, while starting high-quality CPR right away. This rapid shock targets the arrhythmia itself, and CPR maintains perfusion during the interval around the shock. After the first shock, continue CPR and follow ACLS steps (repeat shocks as indicated, give epinephrine every 3–5 minutes, and consider antiarrhythmics like amiodarone if the VT recurs). Synchronized cardioversion is reserved for VT with a pulse, vagal maneuvers don’t treat VT, and giving amiodarone alone isn’t the immediate life-saving action in a pulseless arrest.

Pulseless ventricular tachycardia is a shockable arrest rhythm, so the immediate priority is to deliver an unsynchronized defibrillation to depolarize the heart and reset the rhythm, while starting high-quality CPR right away. This rapid shock targets the arrhythmia itself, and CPR maintains perfusion during the interval around the shock. After the first shock, continue CPR and follow ACLS steps (repeat shocks as indicated, give epinephrine every 3–5 minutes, and consider antiarrhythmics like amiodarone if the VT recurs). Synchronized cardioversion is reserved for VT with a pulse, vagal maneuvers don’t treat VT, and giving amiodarone alone isn’t the immediate life-saving action in a pulseless arrest.