New York State Emergency Medical Technician (EMT) Practice Exam

When managing a patient in cardiac arrest, what is the first step upon applying an AED?

1. Check for a pulse

2. Anally take vital signs

3. Continue CPR for 5 minutes

4. Assess the patient's breathing

The correct answer is: Check for a pulse

The first step upon applying an Automated External Defibrillator (AED) is to check for a pulse. This is crucial because the AED is designed to deliver a shock only if it detects a life-threatening heart rhythm, such as ventricular fibrillation or pulseless ventricular tachycardia. If there is no pulse, it is appropriate to proceed with defibrillation as indicated. The rationale for checking for a pulse lies in ensuring the patient is indeed experiencing cardiac arrest—if a pulse is present, the patient may not benefit from defibrillation and should instead receive appropriate care for their condition. Furthermore, this step aligns with the comprehensive approach in cardiopulmonary resuscitation (CPR), where assessment leads to informed actions. In contrast, methods like assessing the patient's breathing or taking vital signs are secondary to establishing the presence or absence of a pulse, as immediate action in the case of cardiac arrest is critical. Continuing CPR for an extended time without evaluating the situation after using the AED also does not adhere to the protocol, as it can hinder the timely delivery of potentially life-saving shocks.