From the initial comment there are A few things I would insure before shooting electricity through the patient.
1. Check equipment? is there a loose lead or malfunction?
2. How is the patient? Symptomatic?
3. Wide complex QRS (over 0.12ms) is of a ventricular origin. The ventricular rate is 30 to 40 any wide complex over this rate can be considered V-tach as long as there are no P-waves. Maybe even torsades de pointes.
4. Is there a BP or pulse? IF only the ventricles are beating the cardiac output will be bad in a mater of seconds. In this case after CPR and conversion of PEA I would have my pads connected to the patient and lidocaine or amioderon ready to go in case of a deterioration. Remember a symptomatic patient get juice either synchronized or not depending on the pulse. New AHA guidelines state CPR should be performed for two minutes after a rhythm change regardless of pulse due to the lake of oxygen and to help the tired heat muscle.
