In the case of VF or pVT, when should adrenaline and amiodarone be administered?

Adrenaline and amiodarone should be administered after 2 minutes of continuous cardiopulmonary resuscitation (CPR) in cases of ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) for several crucial reasons.

The rationale behind this timing is that immediate defibrillation is the first treatment step for VF or pVT, and it is vital to provide effective chest compressions to optimize the chances of successful defibrillation. Studies have shown that high-quality CPR increases coronary perfusion pressure and helps maintain a viable heart muscle, improving the outcome of subsequent shocks.

After about 2 minutes of CPR, the likelihood of achieving a return of spontaneous circulation improves as the heart's conducting system becomes more responsive to the medication and defibrillation. Administering adrenaline at this point increases coronary perfusion pressure, which is essential for restoring a perfusing rhythm. Amiodarone, an antiarrhythmic, can also assist in stabilizing the heart's electrical activity. This sequencing allows for the best chance of reverting the arrhythmia effectively after the administration of medications.

In contrast, administering these drugs before CPR begins or immediately after the first shock would not maximize the benefit from high-quality