Which action is appropriate after Automated External Defibrillation (AED)?

AIIMS Rishikesh NO - 2019

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Rishikesh NO - 2019

Explanation

According to resuscitation guidelines (AHA), high-quality CPR must be resumed immediately after an AED delivers a shock.
This action minimizes interruptions in chest compressions, which is critical for maintaining perfusion to the brain and heart.
The heart may be stunned (asystole or Pulseless Electrical Activity - PEA) even after a successful shock, and immediate CPR helps it recover a perfusing rhythm.
The AED is programmed to automatically prompt for a rhythm check after about 2 minutes (or 5 cycles) of CPR.

Option A: Checking for a pulse immediately after a shock is a common but dangerous error. It delays chest compressions at a critical moment when the heart needs circulatory support to recover.
Option B: Checking for respirations causes an unnecessary delay in chest compressions. Spontaneous breathing is unlikely to return before a stable, perfusing heart rhythm is established.
Option C: This option combines two incorrect actions, leading to an even longer and more detrimental interruption of life-saving chest compressions.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Post-defibrillation procedure in Basic Life Support (BLS) as background academic context rather than a clinical decision trigger.
High-quality CPR with minimal interruptions is a key determinant of survival from out-of-hospital and in-hospital cardiac arrest. A nurse's ability to correctly follow the BLS algorithm directly impacts patient outcomes.
In a code situation, the team leader or recorder should track 'hands-off' time (time without compressions). Minimizing this time is a primary goal.
What if? If the patient begins to move, open their eyes, and breathe normally immediately after the shock, the rescuer should stop CPR. The next steps would be to check for a pulse, place the patient in the recovery position (if appropriate), and continue to monitor them closely until advanced medical help arrives.

How to Approach the Question

First, identify the question type. This is a process-based question asking for the correct step in a specific clinical protocol (AED use).
Recall the fundamental principles of Basic Life Support (BLS). The most critical principle is to maximize chest compression time and minimize interruptions ('hands-off' time).
Evaluate each option against this core principle. 'Check pulse,' 'Check respiration,' and 'Check pulse and respiration' all involve stopping chest compressions and introducing a delay.
'Resume CPR' is the only option that aligns with the core principle of minimizing interruptions and providing continuous circulatory support.
Conclude that resuming CPR is the correct immediate action after an AED shock, as per standard resuscitation guidelines.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 pp. 45-47, 46-48