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The key steps to treating V-Fib are a rapid assessment to confirm cardiac arrest, starting CPR, applying the defibrillator and delivering the first shock as soon as possible. High quality CPR needs to be performed with as few interruptions as possible by giving cycles of 30 compressions at a depth of 2 to 2.4 inches deep at a rate of 100 to 120 per minute followed by 2 breaths. The compressor needs to be changed every 2 minutes to avoid fatigue. After the initial shock an IV or IO needs to be established in order to give medications. The first medication would be epinephrine, 1 mg 1:10,000 IV or IO push every 3-5 minutes. After the initial dose of epinephrine and a second shock is given, you should consider placing an advanced airway with capnography. Remember that once an advanced airway is in place, CPR compressions become continuous at 100 to 120 compressions a minute, and one breath is given every 6 seconds. The next medication to give is amiodarone, 300 mg via rapid IV or IO push. A 150 mg dose of Amiodarone may repeated one time in 3-5 minutes.