In a shockable rhythm (VF/VT), when should defibrillation be performed?

• A. As soon as feasible after recognition
• B. After epinephrine administration
• C. Only after 5 minutes of CPR
• D. After defibrillation attempts

Answer: (A)

In a shockable rhythm, the priority is to terminate the chaotic electrical activity with a defibrillation shock as soon as it’s recognizable. The heart isn’t effectively pumping, so the quickest path to restoring a perfusing rhythm is to reset the electrical activity right away. Medications and prolonged CPR before delivering the first shock delay a potentially life-saving return of spontaneous circulation and are not as immediately effective as an early shock. After recognizing VF/VT, deliver the defibrillation as soon as feasible, then resume high-quality CPR and continue with subsequent shocks and medications as indicated.