ACLS (Main)

Revision as of 04:40, 12 January 2012 by Rossdonaldson1 (talk | contribs) (Tachycardia (with Pulse))

2010 AHA Recommendation Changes

  • Routine use of cricoid pressure is NOT recommended
  • Airway adjunct is recommended while performing ventilation
  • Pulse/rhythm checks should only occur q2min
  • Most critical component is high-quality compressions
  • Atropine and cardiac pacing are NOT recommended for asystole/PEA

ECG Analysis

  1. Is the rhythm fast or slow?
  2. Are the QRS complexes wide or narrow?
  3. Is the rhythm regular or irregular?


Adult Cardiac Arrest

V-Fib and Pulseless V-Tach

  • Shock as quickly as possible and resume CPR immediately after shocking
    • Biphasic - 200J
    • Monophasic - 360 J
  • Give Epi 1mg if (shock + 2min of CPR) fails to convert the rhythm
  • Give antiarrhythmic if (2nd shock + 2min of CPR) again fails
    • 1st line: Amiodarone 300mg IVP w/ repeat dose of 150mg as indicated
    • 2nd line: Lidocaine 1-1.5 mg/kg then 0.5-0.75 mg/kg q5-10min
    • Magnesium 2g IV, followed by maintenance infusion
      • Only for polymorphic V-tach

Asystole and PEA

  • Give Epi 1mg q3-5min
  • Consider H's and T's
    • Hypovolemia
    • Hypoxia
    • Hydrogen ion
    • Hypo/hyperkalemia
    • Hypothermia
    • Tension pneumo
    • Tamponade
    • Toxins
    • Thrombosis, pulmonary
    • Thrombosis, coronary

Bradycardia (with Pulse)

Tachycardia (with Pulse)

See Also


  • AHA 2010 Guidelines for ACLS