Adult Cardiac Arrest Management Algorithm
Please purchase the course before starting the lesson.
Adult Cardiac Arrest Algorithm
Figure 29
CPR Quality
- Push hard enough to reach 2 inches depth and fast enough for 100 beats per minute, allowing recoil between every press
- Limit interruptions
- Avoid over-ventilating
- If no advanced airway is available,use a 30:2 compression to ventilation ratio
- Perform quantitative waveform capnography (attempt to improve CPR quality if ETCO2 < 10 mmHg
- Monitor intra-arterial pressure (attempt to improve CPR quality if diastolic pressure < 20 mmHg.
Shock Energy
- Biphasic: Older monophasic waveforms are not nearly as effective as the delivery of biphasic energy during defibrillation. For the right doses, stick to manufacturer recommendations; if these are not available, use the maximum setting available.The next doses must be equivalent and potentially higher.
- Monophasic: 360 J
Return of Spontaneous Circulation
- Perform ET intubation or supraglottic advanced airway
- Observe and confirm ET tube placement with waveform capnography
- With continuous chest compressions, apply 8 to 10 breaths every minute
Advanced Airway
- Supraglottic advanced airway or ET intubation
- Waveform capnography to confirm and monitor ET tube placement
- 8 to 10 breaths per minute with continuous chest compressions
Drug Therapy
- Epinephrine IV/IO Dose: 1 mg every 3 to 5 minutes
- Amiodarone IV/IO Dose: initial dose of 300 mg bolus and a second dose of 150 mg
Reversible Causes
- Hypothermia
- Hypo-/hyperkalemia
- Tamponade,cardiac
- Thrombosis, pulmonary, or coronary
- Hypovolemia
- Hypoxia
- H+(acidosis)
- Toxins
- Tension pneumothorax