An 82-year-old male is brought to the ED in PEA arrest. He received 2 mg of epinephrine with EMS and did not have a shockable rhythm on transport. He has a past medical history of type 2 diabetes, hypertension, chronic renal disease and dyslipidemia. He had recently been started on ramipril. On rhythm check, the ECG shows a wide QRS complex with no ST elevation. Bedside ultrasound shows a hypokinetic left ventricle but no regional wall motion abnormalities. Which of the following is the most appropriate immediate treatment other than the ACLS algorithm?

About the Author: Anton Helman

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.