What treatments should be prioritized for patients with shockable rhythms?

• A. Defibrillate as soon as possible; resume CPR immediately after each shock; reassess after every 2 minutes.
• B. Defibrillate after a short delay and focus on airway first
• C. Wait for 5 minutes before defibrillation
• D. Administer epinephrine before any shock

Answer: (B)

When a shockable rhythm is present, the most effective move is to deliver defibrillation as soon as possible. Restoring a normal rhythm early greatly improves the chances of survival because it stops the electrical chaos that’s preventing the heart from pumping effectively.

After you deliver a shock, you should immediately resume high-quality chest compressions. Minimize any pauses to keep perfusion to the heart and brain. Then, recheck the rhythm and pulse at the next two-minute interval and decide whether to shock again or continue CPR and other measures. This cycle—shock, then CPR, then reassessment—maximizes the window of opportunity to achieve return of spontaneous circulation.

Airway management and other interventions are important, but delaying defibrillation to focus on the airway can reduce the likelihood of survival, since time to defibrillation is a critical driver in outcomes for shockable arrests.