An elderly female is found unresponsive. After initiating CPR, the cardiac monitor shows VFib. How should you treat her?

The preferred treatment for a patient found unresponsive with ventricular fibrillation (VFib) is to continue CPR and then prepare to defibrillate at the appropriate energy level. In cases of VFib, defibrillation is a critical step to restore a normal cardiac rhythm, and the standard for defibrillation in adults generally starts at a higher energy level, often around 360 joules, especially when using a biphasic defibrillator, to maximize the chance of converting the arrhythmia effectively.

Continuing CPR before defibrillation helps to maintain blood circulation and oxygen delivery to the brain and vital organs until defibrillation can be performed. The 360J setting is typically indicated for patients with VFib to ensure adequate energy is delivered for synchronization of the cardiac rhythm. Each second of CPR can improve the likelihood of a successful defibrillation, emphasizing the importance of performing high-quality compressions in the interim.

This approach aligns with the advanced cardiac life support (ACLS) protocols, which emphasize the significance of early defibrillation following continued CPR efforts in cases of VFib.