After CPR, which intervention is most important if hypovolemia is suspected?

• A. Defibrillation
• B. Obtain intravenous or IO access
• C. Administer vasopressors
• D. Place patient in Trendelenburg

Answer: (B)

When hypovolemia is suspected during CPR, the top priority is to restore circulating volume, which requires getting rapid access to the bloodstream so fluids (and medications) can be given without delay. Obtaining intravenous or intraosseous access makes volume replacement possible right away, and that step directly addresses the likely cause of the arrest in this scenario.

Defibrillation targets shockable rhythms like VF/VT, which is not the primary issue here if hypovolemia is suspected. Vasopressors can support perfusion, but they do not replace missing volume, so they’re not the immediate first move in suspected hypovolemia. Placing the patient in Trendelenburg is not a recommended resuscitation step for this situation and can worsen breathing or other issues. Once access is secured, proceed with isotonic fluid boluses (and blood products if hemorrhage is suspected) and reassess.