ACLS Cardiac Arrest Algorithm Neumar, R. W. et al. Circulation 2010;122:S729-S767 Copyright ©2010 American Heart Association
Oct 28, 2015
ACLS Cardiac Arrest Algorithm
Neumar, R. W. et al. Circulation 2010;122:S729-S767
Copyright ©
2010 Am
erican Heart A
ssociation
ACLS Cardiac Arrest Circular Algorithm
Neumar, R. W. et al. Circulation 2010;122:S729-S767
Bradycardia Algorithm
Neumar, R. W. et al. Circulation 2010;122:S729-S767
Neumar, R. W. et al. Circulation 2010;122:S729-S767
Tachycardia Algorithm
Post-cardiac arrest care algorithm
Peberdy, M. A. et al. Circulation 2010;122:S768-S786
O'Connor, R. E. et al. Circulation 2010;122:S787-S817
Acute Coronary Syndromes Algorithm
Goals for management of patients with suspected stroke
auch, E. C. et al. Circulation 2010;122:S818-S828J
ACLS Code Drugs Drug Indications Dosage Administration
Adenosine/ Adenocard
Narrow PSVT/SVT Wide QRS Tachy of
uncertain cardiac origin
6 mg followed by 12mg in 1-2 min.
Rapid IV push close to the hub followed by a saline bolus.
Amiodarone Vfib/pulseless VT, VT with a pulse. May be used for rate control of WPW or atrial tachycardias.
300mg IVP for cardiac arrest. Consider repeating with 150mg in 3-5 min. 150mg over 10 min for stable VT, may repeat 150mg every 10 min as needed. Cumulative dose of 2.2 IV in 24 hrs. Slow infusion 360mg IV over 6 hrs, maintenance 540mg over 18 hrs. (0.5mg/min)
Draw up with filtered needle. Administer drip with filtered tubing. Gtt infusion mixed 900mg/500 D5W. 1mg/min = 33.3cc/hr .5mg/min = 16.6cc/hr Half life is up to 40 days.
Atropine Symptomatic sinus bradycardia.
.5 mg IV every 3-5 min for bradycardia, not to exceed 3 mg Tracheal 2-3mg diluted in 10cc NS.
Do not give less than 0.5mg IV. May be given IV, IO, or ET Does not work with heart transplant patients due to denervation.
Calcium Chloride Known or suspected hyperkalemia (renal fx). Hypocalcemia after multiple blood tx. Antidote for calcium channel blockers or beta blocker overdose
8-16mg/kg IV for hyperkalemia and calcium channel blocker overdose.
Do not mix with sodium bicarbonate.
Dopamine Used for hypotension with signs and symptoms of shock or bradycardia
Mixed 400mg/250D5W 2-10mcg/kg/min.
IV line must be a good one. Will cause extravasation with infiltration Do not mix with sodium bicarbonate.
Epinephrine Cardiac arrest, VF, pulseless VT, asystole, PEA Symptomatic bradycardia, severe hypotension, anaphylaxis
Cardiac arrest: 1mg of the 1:10,000 administered q 3-5 min follow each dose with IV flush. Bradycardia or hypotension use a gtt.
1mg/250cc: 1mcg/min = 15 cc/hr. May be given IV, IO or ET
Drug Indications Dosage Administration Magnesium Sulfate Torsades de pointes or
suspected hypomagnesemia. Life threatening arrhythmias due to dig toxicity.
1-2 gm diluted in 10 cc D5W IVP if in cardiac arrest. If not in cardiac arrest mix 1-2 gm in; 50 to 100 cc D5W to infuse over 5 to 60 min.
May cause fall in BP with rapid administration. Use with caution if renal failure is present.
Morphine Sulfate Used for treatment of ischemic chest pain, acute cardiogenic pulmonary edema, anxiety Decreases the myocardial preload and causes peripheral venous pooling.
Dosage should be in 1 to 2 mg increments up to 10 mg max
Given slow IV over 1-2 min Precautions: respiratory depression and hypotension
Narcan/Naloxone Used to reverse respiratory depression that results from narcotics Also used for coma of unknown etiology
Dosage – 0.4 mg to 2 mg IV or IO and may be given ET
IV or IO meds should be given over 1 min. Precautions: If given rapidly IV/IO can cause projectile vomiting Patient may become agitated or violent
Procainamide Anti-arrhythmic for stable wide QRS Tachycardia
20-50 mg/min End Points: Arrhythmia suppressed, hypotension ensues, QRS duration increase >50%, max dose 17 mg/kg
Sotalol Hemodynamically Stable Monomorphic Ventricular Tachycardia 3rd Line Anti-Arrhythmic
100 mg over 5 min or 1.5 mg/kg over 5 min
Avoid if prolonged QT
Sodium Bicarbonate Preexisting hyperkalemia, metabolic acidosis, prolonged resuscitation.
1 meq/kg IV bolus. Repeat half dose q 10 min
Not recommended for routine use in cardiac arrest patients.
Vasopressin May be used as an alternative pressor to epi in the treatment of Cardiac Arrest instead of 1st or 2nd dose of epi
IV, IO 40 U IV push X 1 dose only. ET 80U X 1 dose only
Do not give any epi for 10 min after vosopressin is given.
Compiled by: Rebecca Cass, NREMT-P
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