Basic resuscitation: witnessed ventricular fibrillation: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Basic resuscitation: witnessed ventricular fibrillation

Sample item

A patient on a cardiac monitor in the coronary care unit suddenly develops ventricular fibrillation, witnessed by the nurse, and a defibrillator is at the bedside. What is the first action?

AGive two minutes of CPR before analysing the rhythmBSecure the airway with a tracheal tubeCGive amiodarone 300 mg intravenouslyDDeliver a shock at once

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Deliver a shock at once

Survival in ventricular fibrillation falls with each minute without defibrillation. When the arrest is witnessed and monitored and a defibrillator is immediately available, the shock is delivered first, followed by immediate resumption of compressions. Drugs and airway management come later.

Option by option

A. Give two minutes of CPR before analysing the rhythm
Delaying the shock for CPR is not needed when the arrest is witnessed and the defibrillator is ready.
B. Secure the airway with a tracheal tube
Airway control should not delay defibrillation of ventricular fibrillation.
C. Give amiodarone 300 mg intravenously
Amiodarone is considered after repeated shocks, not before the first one.
D. Deliver a shock at once (correct)
Correct. Immediate defibrillation gives the best chance of restoring a perfusing rhythm.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Deliver a shock at once. Survival in ventricular fibrillation falls with each minute without defibrillation.

Why is "Give two minutes of CPR before analysing the rhythm" not the answer?

Delaying the shock for CPR is not needed when the arrest is witnessed and the defibrillator is ready.

Why is "Secure the airway with a tracheal tube" not the answer?

Airway control should not delay defibrillation of ventricular fibrillation.

Why is "Give amiodarone 300 mg intravenously" not the answer?

Amiodarone is considered after repeated shocks, not before the first one.

What concept does this question test?

It tests Basic resuscitation: witnessed ventricular fibrillation in Anaesthesia. When the arrest is witnessed and monitored and a defibrillator is immediately available, the shock is delivered first, followed by immediate resumption of compressions. Drugs and airway management come later.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Basic resuscitation: witnessed ventricular fibrillation?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.