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Adult Cardiac Arrest Management Algorithm

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Adult Cardiac Arrest Algorithm

ACLS Adult Cardiac Arrest Algorithm

FigureĀ 29

CPR Quality

  • Push hard enough to reach 2-2.4″ (5-6 cm) depth and fast enough for 100-120 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

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
  • 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 the second dose of 150 mg
  • Lidocaine: 1st dose: 1-1.5 mg/kg, second dose: 0.5-0.75 mg/kg

Reversible Causes

  • Hypovolemia
  • Hypoxia
  • H+(acidosis)
  • Hypothermia
  • Hypo-/hyperkalemia
  • Hypoglycemia
  • Tamponade, cardiac
  • Toxins
  • Tension pneumothorax
  • Thrombosis, pulmonary or coronary
  • Trauma

Advanced Cardiac Life Support (ACLS) Certification Course

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