Which rhythms are considered shockable in adult ACLS?

Which rhythms are considered shockable in adult ACLS?

• A. Atrial fibrillation with rapid ventricular response
• B. Asystole and pulseless electrical activity (PEA)
• C. Normal sinus rhythm
• D. Ventricular fibrillation and pulseless ventricular tachycardia

Answer: (D)

In adult ACLS, defibrillation is used for rhythms that are nonperfusing due to chaotic or rapid electrical activity. Ventricular fibrillation and pulseless ventricular tachycardia fit this because there’s no effective cardiac output; a high-energy shock can interrupt the disordered electrical activity and allow a new perfusing rhythm to emerge when CPR continues and underlying causes are addressed. Atrial fibrillation with rapid ventricular response isn’t treated with defibrillation in this context since it usually has an organized rhythm and a pulse. If the patient were unstable with a pulse, synchronized cardioversion might be considered, but not unsynchronized defibrillation during a non-arrest situation. Normal sinus rhythm is already normal and doesn’t require shock. Asystole and pulseless electrical activity lack a meaningful, effective electrical rhythm to reset with a shock; the approach is CPR plus medications and addressing reversible causes rather than defibrillation.

In adult ACLS, defibrillation is used for rhythms that are nonperfusing due to chaotic or rapid electrical activity. Ventricular fibrillation and pulseless ventricular tachycardia fit this because there’s no effective cardiac output; a high-energy shock can interrupt the disordered electrical activity and allow a new perfusing rhythm to emerge when CPR continues and underlying causes are addressed.

Atrial fibrillation with rapid ventricular response isn’t treated with defibrillation in this context since it usually has an organized rhythm and a pulse. If the patient were unstable with a pulse, synchronized cardioversion might be considered, but not unsynchronized defibrillation during a non-arrest situation. Normal sinus rhythm is already normal and doesn’t require shock.

Asystole and pulseless electrical activity lack a meaningful, effective electrical rhythm to reset with a shock; the approach is CPR plus medications and addressing reversible causes rather than defibrillation.