Cardiac Arrest

CARDIAC ARREST

VENTRICULAR FIBRILLATION/PULSELESS V-TACH

Patient unconscious, apneic and pulseless from medical etiology. Precordial thump may be used in a witnessed arrest.

BASIC EMT A-EMT PARAMEDIC

Assess ABC’s Assess ABC’s Assess ABC’s

Initiate CPR; apply Initiate CPR; apply Initiate CPR; apply AED if possible AED if possible EKG monitor/defibrillator

Check pulse; if absent Check pulse; if absent & AED available, follow & AED available, follow For Ventricular fibrillation: Defibrillate once at: instructions for defibrillations or: instructions for defibrillations or: Biphasic: 200J Biphasic (Zoll): 120J* Biphasic (Zoll): 120J* Biphasic (Zoll): 120J* CPR for 2 minutes, then CPR for 2 minutes, then CPR for 2 minutes, then check pulse check pulse check pulse Consider Airway Mgt.

If sustained ventricular fibrillation, repeat cycles of: If sustained ventricular If sustained ventricular 1. rhythm analysis fibrillation, repeat cycles of: fibrillation, repeat cycles of: 2. defibrillation 1. rhythm analysis 1 rhythm analysis 3. 2 minutes CPR 2. defibrillation 2 defibrillation 4. then pulse check 3. 2 minutes CPR 3 2 minutes CPR 4. then pulse check 4 Then pulse check Establish IV / IO MAX 2L

Ventilate with 100% O2 Establish IV NS TKO Adm Epinephrine 1mg IVP Repeat every 3 min as indicated Transport as soon as possible Intubate & ventilate w/100% O2 during protocol to closest medical 10-12 ventilations/minute max facility. Call for ALS intercept if Adm Amiodarone IVP or available. Establish contact with Lidocaine 1.5mg/kg IVP hospital enroute. Transport as soon as possible during protocol to closest medical

facility. Call for ALS intercept if available. Establish contact with Intubate, Ventilate w/100% O2 hospital enroute. 8 ventilations/minute max

Rapid Transport as soon as *Subsequent defibrillations with Zoll brand biphasic possible defibrillators may be escalated up to 200J (i.e. 150J, 200J) or repeated at 120J each time. . Establish contact with hospital enroute. The most important aspect of cardiac arrest resuscitation is good quality CPR. It should be fast (100/min) and deep (2 inches/adult) and uninterrupted (not for IVs, intubation or movement).

Amiodarone 300mg 1st dose, repeat at 150mg 2nd dose in 5 minutes IVP. Lidocaine can be repeated in 5min

to a 3 mg/kg max.