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Adult Cardiac Arrest Circular Algorithm: Monitor CPR Quality

ACLS CARDIAC ARREST Algorithm 2020

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Alexis Hospital
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213 views

Adult Cardiac Arrest Circular Algorithm: Monitor CPR Quality

ACLS CARDIAC ARREST Algorithm 2020

Uploaded by

Alexis Hospital
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Adult Cardiac Arrest Circular Algorithm

CPR Quality

• Push hard (at least 2 inches [5 cm]) and fast (100-120/min) and
allow complete chest recoil.
• Minimize interruptions in compressions.
• Avoid excessive ventilation.
• Change compressor every 2 minutes, or sooner if fatigued.
Start CPR • If no advanced airway, 30:2 compression-ventilation ratio.
• Give oxygen • Quantitative waveform capnography
• Attach monitor/defibrillator – If Petco2 is low or decreasing, reassess CPR quality.

Return of Spontaneous Shock Energy for Defibrillation


2 minutes Circulation (ROSC)
• Biphasic: Manufacturer recommendation (eg, initial dose of
Check Post–Cardiac 120-200 J); if unknown, use maximum available. Second and
Rhythm Arrest Care subsequent doses should be equivalent, and higher doses may
If VF/pVT
Shock be considered.
• Monophasic: 360 J
Drug Therapy Drug Therapy
IV/IO access
Co
R

Epinephrine every 3-5 minutes


uous CP

• Epinephrine IV/IO dose: 1 mg every 3-5 minutes


Amiodarone or lidocaine
ntinuous CP

for refractory VF/pVT • Amiodarone IV/IO dose: First dose: 300 mg bolus. Second
dose: 150 mg.
or
Consider Advanced Airway • Lidocaine IV/IO dose: First dose: 1-1.5 mg/kg. Second dose:
Quantitative waveform capnography
ntin

0.5-0.75 mg/kg.

Advanced Airway
o

Treat Reversible Causes


R
C

• Endotracheal intubation or supraglottic advanced airway


• Waveform capnography or capnometry to confirm and monitor
Mo
nitor C lity ET tube placement
PR Qua • Once advanced airway in place, give 1 breath every 6 seconds
(10 breaths/min) with continuous chest compressions

Return of Spontaneous Circulation (ROSC)

• Pulse and blood pressure


• Abrupt sustained increase in Petco2 (typically ≥40 mm Hg)
• Spontaneous arterial pressure waves with intra-arterial
monitoring

Reversible Causes

• Hypovolemia • Tension pneumothorax


• Hypoxia • Tamponade, cardiac
• Hydrogen ion (acidosis) • Toxins
• Hypo-/hyperkalemia • Thrombosis, pulmonary
• Hypothermia • Thrombosis, coronary
© 2020 American Heart Association

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