VT/VF/Cardiac Arrest

A 59-year-old male known to have ischemic cardiomyopathy (EF 30%) and type 2 diabetes, suddenly collapses at a bus stand. On arrival at the emergency department:

• He is unresponsive, pulseless, and not breathing.
• ECG monitoring shows ventricular fibrillation (VF).
• Random blood glucose: 178 mg/dl
• Serum potassium: 4.6 mg/dl
• Creatinine: 1.1 mg/dl

CPR is initiated immediately, and a defibrillator is attached. During the ACLS debriefing session, the residents discuss the correct principles of defibrillation. Which of the following statements regarding defibrillation is incorrect?

A 62-year-old male with a history of long-standing hypertension and ischemic heart disease presents to the emergency department with sudden-onset palpitations, dizziness, and near-syncope.

On examination:

• BP: 90/60 mmHg
• Pulse: 160/min, irregularly regular
• Jugular venous pulse is elevated
• Lungs are clear on auscultation

Initial investigations:

• Random blood glucose: 132 mg/dl
• Serum creatinine: 1.3 mg/dl
• Serum potassium: 4.2 mg/dl
• Troponin-I: negative

His ECG shows a broad complex tachycardia (QRS > 140 ms). During the ward round, the team debates whether this rhythm represents ventricular tachycardia (VT) or supraventricular tachycardia (SVT) with aberrant conduction. Which of the following ECG features would most strongly indicate ventricular tachycardia in this scenario?

A middle-aged man presented to the emergency department with palpitations. Upon examination, he displayed a pulse rate of 125/min and a blood pressure of 120/70. The ECG indicated a broad complex tachycardia. Which of the following medications should be avoided?

A middle-aged female arrived at the hospital’s emergency department as an attendant. However, she collapsed, and examination revealed no palpable pulse. An immediate ECG indicated ventricular tachycardia. What is the next most suitable course of action?

An individual with palpitations was brought to the emergency department. During examination, the patient exhibited significant distress, along with symptoms of shortness of breath and sweating. The pulse rate recorded was 170/min, and the blood pressure was 88/55. ECG showed broad complex tachycardia. What is the most suitable approach for managing this patient?