Pulseless arrest: Difference between revisions
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*[[Cardiac Arrest Management]] | *[[Cardiac Arrest Management]] | ||
*[[Post Cardiac Arrest]] | *[[Post Cardiac Arrest]] | ||
*A (adjunct) - Place oropharyngeal airway | |||
*B (breathing) - place on ventilator to assure slow ventilation rate (attach to BVM mask) | |||
**10-12 bpm, 500cc tidal volume, Fio2 100% | |||
*C (compressions) - Switch out providers q pulse check; use metronome | |||
*D - defibrillation | |||
**Ok to shock during compressions if wearing gloves and using biphasic device | |||
*A (advanced airway) | |||
**Use LMA (NOT ET tube - no break in compressions required) | |||
*B (advanced breathing) | |||
**Connect LMA to ventilator | |||
***Pressure control 20, RR 10, insp rate 1.5-2s | |||
*C (advanced circulation) | |||
**Place IO instead of central line | |||
*D (differential) | |||
**[[Ultrasound: In Shock and Hypotension]] | |||
==See Also== | |||
*[[ACLS (Main)]] | |||
*[[Brain Death]] | |||
*[[Adult Cardiac Arrest]] | |||
*[[Post Cardiac Arrest]] | |||
==Source== | |||
*EMCrit Podcast #31 | |||
[[Category:Airway/Resus]] | |||
Revision as of 05:00, 12 January 2012
Immediate
- Start CPR
- Give oxygen
- Attache monitor/defibrilator
- Rhythm shockable?
V-Fib and Pulseless V-Tach (Shockable)
- 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 (Non-Shockable)
- 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
See Also: ACLS (Treatable Conditions)
See Also
- A (adjunct) - Place oropharyngeal airway
- B (breathing) - place on ventilator to assure slow ventilation rate (attach to BVM mask)
- 10-12 bpm, 500cc tidal volume, Fio2 100%
- C (compressions) - Switch out providers q pulse check; use metronome
- D - defibrillation
- Ok to shock during compressions if wearing gloves and using biphasic device
- A (advanced airway)
- Use LMA (NOT ET tube - no break in compressions required)
- B (advanced breathing)
- Connect LMA to ventilator
- Pressure control 20, RR 10, insp rate 1.5-2s
- Connect LMA to ventilator
- C (advanced circulation)
- Place IO instead of central line
- D (differential)
See Also
Source
- EMCrit Podcast #31