Rapid Response RN

The shock worked. The rhythm converted. And then V-fib came right back. Now what?
Part two of this series explores the physiology and pharmacology driving recurrent V-fib so you can respond confidently when shocks aren’t enough.
You'll learn how the body's sympathetic nervous system response keeps the heart unstable, why epinephrine can both help and hurt, when to reach for lidocaine over amiodarone, and what the research says about the emerging role of esmolol to target the storm itself (not just the arrhythmia).
Topics discussed in this episode:
The sympathetic nervous system and cardiac arrest
Why epinephrine both helps and hurts
Amiodarone vs. lidocaine: which is better?
Key findings from the ROC-ALPS trial
Why antiarrhythmics don't replace defibrillation
The evidence behind esmolol in refractory V-fib
3 lessons for codes when ACLS isn't enough

Mentioned in this episode:
CONNECT
📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/

📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore

🧑‍💻Check out my website: https://www.rapidresponseandrescue.com/

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🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern

✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541


SAY THANKS
💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752

💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE


⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

This episode was produced by Podcast Boutique https://www.podcastboutique.com

This special episode was recorded and released on the Nurse Gwenny Podcast. We talked about some of those early signs of deterioration that are often missed and how we can speak up and advocate before the patient crashes.
Check out this episode and so many more over at the Nurse Gwenny Podcast
And, you can join the Nurse Gwenny Library to earn CE credits for listening to the show!
Use code: rapidresponsern
to get a discount on your membership:
https://library.nursegwenny.com/bundles/nurse-gwenny-library-membership

Sometimes V-fib doesn't respond to the shock at all. Sometimes it converts and comes right back. Those are two completely different problems.
In this episode, Sarah breaks down the science behind why defibrillation fails, how to recognize the difference between refractory and recurrent V-fib, and respond when shocks aren't working. You'll learn how to start approaching the electrical storm at the bedside — that means understanding transthoracic impedance, optimizing your pad placement, and knowing when to reach for double sequential defibrillation.
Topics discussed in this episode:
Refractory vs. recurrent V-fib
The physiology of ventricular fibrillation and re-entry tachycardias
Misconceptions about defibrillation
Transthoracic impedance and how to reduce it
Anterior-lateral vs. anterior-posterior pad placement
Double sequential defibrillation: evidence and objections
Key findings from the DOSE VF trial

American Heart Association. (2025). 2025 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation.
Cheskes, S., Dorian, P., Feldman, M., McLeod, S., Scales, D. C., Pinto, R., Turner, L., Morrison, L. J., Drennan, I. R., & Verbeek, P. R. (2020). Double sequential external defibrillation for refractory ventricular fibrillation: The DOSE VF pilot randomized controlled trial. Resuscitation, 150, 178–184. https://doi.org/10.1016/j.resuscitation.2020.02.010
D. Hasegawa, A. Sharma, Y. I. Lee, & R. Sato. (2023). A systematic review and meta-analysis of esmolol for refractory ventricular fibrillation and pulseless ventricular tachycardia. Chest, 164(4 Suppl.), A1568. https://doi.org/10.1016/j.chest.2023.07.1077
International Liaison Committee on Resuscitation. (2025). 2025 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR).
Mentioned in this episode:
CONNECT
📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/

📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore

🧑‍💻Check out my website: https://www.rapidresponseandrescue.com/

📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login

🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern

✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541


SAY THANKS
💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752

💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE


⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

This episode was produced by Podcast Boutique https://www.podcastboutique.com

Imagine being able to cut your hospital's code blue events outside of critical care in HALF in just six months. That's exactly what happened when Sarah built her hospital's rapid response team from the ground up.
Nurse Gwenny takes over the show to find out how she did it, from the pitch that got the program started to the skills that actually matter on rapid response teams. She also shares what disqualifies a candidate even when the resume is perfect, why so few resources exist for rapid response training, and how she’s filling that gap herself.
Whether you're hoping to start a rapid response program at your hospital or just want to feel more confident the next time you call one, this episode is for you.
Topics discussed in this episode:
How Sarah became a rapid response nurse
The backstory behind the Rapid Response RN Podcast
The impact of having a rapid response team
How you can start a rapid response program
Rapid response education and (lack of) resources
Hiring red flags that override a strong resume
Soft skills nursing school never teaches
Trusting nursing intuition when vitals look fine

Join the Nurse Gwenny Library to earn CE credits for listening to the show!
Use code: rapidresponsern
to get a discount on your membership:
https://library.nursegwenny.com/bundles/nurse-gwenny-library-membership
Mentioned in this episode:
CONNECT
📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/

📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore

🧑‍💻Check out my website: https://www.rapidresponseandrescue.com/

📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login

🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern

✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541


SAY THANKS
💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752

💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE


⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

This episode was produced by Podcast Boutique https://www.podcastboutique.com

We all know the many challenges facing the Nursing profession today. Nursing takes so much from us… but it also has so much to offer.
Recorded live at NurseCon at Sea, Sarah sits down with two nurses who hit their breaking point and found a way to keep showing up. This episode goes deep into the messy reality of nursing burnout, from the struggle to put yourself first to the boundaries, mindset shifts, and support systems that keep nurses in the game.
You don't have to manage burnout alone, so don’t miss this one.
Topics discussed in this episode:
Self-care and resilience as a discipline
The nursing choice: fracture or adapt
Building a life that isn't fully defined by the institution
Important things we don’t say to each other
What patients actually need from their nurses
Therapy, medication, and sleep as nursing tools
An exercise to audit your cup-fillers vs. cup-drainers
Why it’s so important to share your experience
How leaders should respond when a nurse is nearing burnout

Learn more about NurseCon at Sea:
https://nurseconatsea.com/
Mentioned in this episode:
CONNECT
📸 Connect on Instagram: https://www.instagram.com/therapidresponsern/

📚 Check out my course: https://www.rapidresponseandrescue.com/learnmore

🧑‍💻Check out my website: https://www.rapidresponseandrescue.com/

📬 Subscribe to my newsletter: https://www.rapidresponseandrescue.com/login

🎁 Affiliation and discounts: https://www.rapidresponseandrescue.com/therapidresponsern

✅ Earn CE’s for listening to podcasts through RNegade: https://rnegade.thinkific.com/?ref=d9d541


SAY THANKS
💜Leave a review on Apple Podcasts: https://podcasts.apple.com/ca/podcast/rapid-response-rn/id1535997752

💚Leave a rating on Spotify: https://open.spotify.com/show/55LQqeDg6XFeixvZLEp4xE


⏱️ To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

This episode was produced by Podcast Boutique https://www.podcastboutique.com