Adult Post V-Fib/V-Tach ROSC management includes which of the following after ROSC?

• A. Labetalol infusion
• B. Amiodarone Infusion: 150mg in 100ml over 10 minutes
• C. Epinephrine infusion
• D. Magnesium sulfate infusion 2g in 100ml, 10 drop set, wide open

Answer: (B)

After ROSC from a shockable arrest, the priority is to prevent recurrent VT/VF while stabilizing the patient. Amiodarone is the preferred antiarrhythmic in this post-arrest setting because it effectively reduces recurrent ventricular arrhythmias and is well tolerated in the hospitalized/post-arrest population. Administering 150 mg of amiodarone in 100 mL over 10 minutes provides a rapid antiarrhythmic effect and is a common way to address ongoing or imminent VT/VF after ROSC, with the option for additional dosing or infusion per protocol if needed.

Labetalol infusion is a beta-blocker and is not used as the primary antiarrhythmic in this context, since post-arrest patients can be hemodynamically fragile and hypotension is a concern. Epinephrine infusion is mainly a resuscitation medication to support perfusion during arrest, and while it may be used for blood pressure support after ROSC, it is not the standard choice to treat recurrent VT/VF. Magnesium sulfate is specifically indicated for torsades de pointes or hypomagnesemia-related scenarios, not as a general post-arrest antiarrhythmic for VT/VF.