Which rhythms are nonshockable?

Which rhythms are nonshockable?

• A. Ventricular Fibrillation
• B. Ventricular flutter
• C. Pulseless Electrical Activity and Asystole
• D. Pulseless Ventricular Tachycardia

Answer: (C)

A rhythm without a pulse that shows no organized electrical activity or contractile effort cannot be corrected with a shock. In ACLS, defibrillation works when electrical chaos is present but there is no effective chest movement—this is what happens in ventricular fibrillation and pulseless ventricular tachycardia. Ventricular flutter is also typically treated with defibrillation. In contrast, pulseless electrical activity and asystole either have no mechanical contraction (PEA) or no electrical activity at all (asystole), so shocking won’t restore a pulse. The best approach here is high‑quality CPR, correct reversible causes, and medications like epinephrine. Thus, pulseless electrical activity and asystole are nonshockable.

A rhythm without a pulse that shows no organized electrical activity or contractile effort cannot be corrected with a shock. In ACLS, defibrillation works when electrical chaos is present but there is no effective chest movement—this is what happens in ventricular fibrillation and pulseless ventricular tachycardia. Ventricular flutter is also typically treated with defibrillation. In contrast, pulseless electrical activity and asystole either have no mechanical contraction (PEA) or no electrical activity at all (asystole), so shocking won’t restore a pulse. The best approach here is high‑quality CPR, correct reversible causes, and medications like epinephrine. Thus, pulseless electrical activity and asystole are nonshockable.