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Pulseless VT/VF Resuscitation Algorithm

This document provides an overview of the pulseless ventricular tachycardia/ventricular fibrillation algorithm according to the 2005 emergency cardiac care guidelines. It outlines the steps to take when assessing an unresponsive patient, including opening the airway, giving breaths, checking for a pulse and attaching an AED or monitor to assess the heart rhythm. It describes delivering shocks if the rhythm is shockable and performing CPR, and considering vasopressors, antiarrhythmics or other treatments as indicated based on the patient's rhythm and response to treatment. The full algorithm is depicted in a figure to guide resuscitation efforts.

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Maya Aritonang
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67 views1 page

Pulseless VT/VF Resuscitation Algorithm

This document provides an overview of the pulseless ventricular tachycardia/ventricular fibrillation algorithm according to the 2005 emergency cardiac care guidelines. It outlines the steps to take when assessing an unresponsive patient, including opening the airway, giving breaths, checking for a pulse and attaching an AED or monitor to assess the heart rhythm. It describes delivering shocks if the rhythm is shockable and performing CPR, and considering vasopressors, antiarrhythmics or other treatments as indicated based on the patient's rhythm and response to treatment. The full algorithm is depicted in a figure to guide resuscitation efforts.

Uploaded by

Maya Aritonang
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

430

ACLS STUDY GUIDE

Pulseless Ventricular Tachycardia/Ventricular Fibrillation


Algorithm (Figure 8-5)
Pulseless VT/VF Algorithm
First Impression: Sick or not sick?
Primary survey
Unresponsive?
Open airway, give 2 breaths
Give oxygen when available
If no pulse, 30 compressions/2 breaths
Attach AED or monitor/defibrillator

Updated! Barbara Aehlerts unique treatment


algorithms are user friendly and easy to
remember and all have been completely
revised to reflect the 2005 emergency cardiac
care guidelines, ensuring you are learning the
most up-to-date information available.

Assess ECG rhythm


Shockable?

YES
Shock (defibrillate)  1
Resume CPR5 cycles (about 2 minutes)
Without interrupting CPR, start IV/IO
During CPR, give vasopressor
Epinephrine 1 mg every 3-5 min
OR
Vasopressin 40 U  1 in place
of first or second epinephrine dose

NO

Asystole?
Go to asystole algorithm
Electrical activity present?
Check pulse
No pulse, go to PEA algorithm
Pulse present? Assess vital signs,
begin postresuscitation care

REASSESS/MONITOR
Airway
Oxygenation/ventilation
Paddle/pad position/contact
Effectiveness of CPR
No O2 flowing over patient
during shocks
Attempt/verify:
Advanced airway placement
Vascular access
Monitor and treat:
Glucose
Electrolytes
Temperature
CO2

SHOCKS
Defibrillation
Monophasic: 360J all shocks
AED: Per manufacturer
Biphasic: Per manufacturer
Biphasic unknown: 200J
initially, then same or higher
as first shock
REVERSIBLE CAUSES

NO

Assess ECG rhythm


Shockable?

YES
Shock (defibrillate)  1
Resume CPR5 cycles (about 2 minutes)
During CPR, consider antiarrhythmic
Amiodarone 300 mg IV/IO initial dose; consider
repeat dose of 150 mg  1 in 5 min
OR
Lidocaine 1-1.5 mg/kg IV/IO initial dose
(if amiodarone not available),
then 0.5-0.75 mg/kg prn every 5-10 min;
max cumulative dose 3 mg/kg
Consider magnesium 1-2 g IV/IO
for torsades de pointes
Consider reversible causes of arrest

Pulmonary embolism
anticoagulants? surgery?
Acidosisgive oxygen,
ensure adequate ventilation
Tension pneumothorax
needle decompression
Cardiac tamponade
pericardiocentesis
Hypovolemiareplace
volume
Hypoxiagive oxygen,
ensure adequate ventilation
Heat/coldcooling/warming
measures
Hypohyperkalemia (and
other electrolytes) correct
electrolyte abnormalities
Myocardial infarction
fibrinolytics?
Drug overdose/accidents
antidote/specific therapy

Algorithm assumes scene safety has been assured, personal protective


equipment is used, no signs of obvious death or presence
of do not resuscitate order, and previous step was unsuccessful

Figure 8-5 Pulseless VT/VF algorithm.

Ch08-A4695_417-[Link] 430

6/30/06 [Link] AM

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