While monitoring a patient in ventricular tachycardia, what should be done prior to cardioversion?

• A. Call "Clear"
• B. Set defibrillation to 360 joules
• C. Administer sodium bicarbonate
• D. Ensure synchronization is active

Answer: (D)

When a patient is in ventricular tachycardia and requires cardioversion, ensuring that synchronization is active is crucial. Synchronization helps to deliver the electrical shock during the optimal phase of the cardiac cycle, specifically just before a QRS complex occurs. This timing minimizes the risk of inducing ventricular fibrillation, which could happen if an unsynchronized shock is delivered during the vulnerable period of the cardiac cycle.

In this context, activating synchronization means that the cardioversion device can monitor the patient's heart rhythm and will only administer the shock when the rhythm is appropriate, usually synchronized to the R wave of the QRS complex. This is vital in treating conditions like stable ventricular tachycardia where the goal is to restore normal rhythm safely.

Other choices provided do not address this critical aspect of shock delivery and thus do not align with the best practice for performing cardioversion effectively and safely.