Fine VF or Asystole?

If there is doubt about whether the rhythm is asystole or very fine VF, revert to the non-shockable arm of the algorithm, since:

• True fine VF is unlikely to be shocked successfully
• Repeated shock of fine VF or asystole will cause myocardial injury, from both the electricity delivered and the interruptions to CPR
• Quality CPR may increase the amplitude of fine VF, permitting a successful shock

Learning bite

If you suspect fine VF, revert to the non-shockable arm of the ALS algorithm.