A patient in cardiac arrest due to acute myocardial infarction (AMI) is being prepared for transport. Despite advanced cardiac life support (ACLS) interventions, the patient remains in cardiogenic shock. Which of the following interventions is most effective to improve myocardial perfusion and decrease myocardial workload during transport?
The administration of an inotropic agent like dobutamine is the most effective intervention in this scenario. Dobutamine increases cardiac output by enhancing myocardial contractility and improving stroke volume. This optimizes cardiac perfusion and helps to decrease myocardial workload, which is crucial in managing cardiogenic shock. While defibrillation is essential in life-threatening arrhythmias and fluid administration is critical in hypovolemic shock, they are not as directly effective in improving myocardial perfusion and reducing cardiac workload in cardiogenic shock due to AMI. Administering nitroglycerin primarily affects preload and coronary vasodilation but does not address myocardial contractility as effectively as dobutamine.
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BCEN CFRN
Resuscitation Principles
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