Adult Cardiac Arrest
Algorithm— 2015 Update
Advanced Cardiovascular Life Support
Start CPR
* Give oxygan
+ Attach monitor/detirilator
: Yes Rhythm wo
FC sthockable?,
( — vos
Asystole/PEA
CPR 2 min
IV/O access
| v0 CPR 2 min
+ Ivi0 access
+ Epinephrine every 3-5 min
+ Consider advanced airway,
capnography
6
fe CPR 2 min
+ Epinephrine every 3-5 min
* Consider advanced airnay,
‘capnography
Rhythm
shockable?,
Rhythm
shockable?
CPR 2 min
+ Theat reversible causes
shockable?
* fn signs of return of
spontaneous circulation
(ROSO), go 10 10 oF 11
+ IFROSC, go 19
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‘Start CPR
* Give oxygen
* Attach monitor/defibrillator
Return of Spontaneous
Circulation (ROSC)
2 minutes
Drug Therapy
IVIO access
\ephrine every 3-5 minutes
\darone for refractory VF/pVT
Se ‘Drug Therapy er
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‘+ Push hard at east 2inene (5 omy) ana
fast (100-120/mn and allow complete
fe smeruptons in compressions
tate compressor every 2 minutes, or
sooner fat gue
+ If r@ advanced airway, 0:
vention rato.
+ uanttatve wavetorm capnagraphy
=i Pereo,<10 mn Hg, atop to
*+ Epinephrine WO dose!
+ Amiodarone VIO dose:
Fst dose 300 mg bobs.
‘sean ose’ 150 m9)
‘+ Pusan Hood pressure
(pypicany 240 mm 4) i
+ Spontaneous arterial pressure waves vith
itraartonal monitoring
ere
Reversible Causes
compression
+ Endotacheal intubation or supraglttie
advanced away + Mypovoienia
+ Waveform capnograpty or capnometry to
| + inrocareral pressure ‘vanced arway in pace, give
= Wreiaxation phase (ciastofe) presaure | breath every 6 secands (10 treat
<20 mm Hg, attempt foimprave CPR | wit continous or
yaregen ion acidosis)
9 ryperkaieia
+ Hypothermia
1 Tension pneumothorax
%
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Identity and treat underlying cause
PEON altlel eg Oeten eel
bradyarrhythmia causing:
*+ Hypotension?
* Acutely altered mental status?
Signs of shock?
‘+ Ischemic chest discomtort?
* Acute heart tallure?
Atropine
If atropine ineffective:
+ Transoutaneous pacing
Sd
‘Atropine IV dose:
First dose: 0.5 mg bolus.
Repeat every 3-8 minutes.
‘Maxtenum: 3 mg,
Dopamine IV intusion:
Usual infusion rate is
2:20 mog/kg per minute,
“Titate to patient response;
taper slowly.
Epinephrine 1V infusion:
2-10 meg per minute
infusion. Titrate to patient
response
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