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Advanced Cardiac Life Support 7

Cardiology

Advanced Cardiac Life Support

ALGORITHM FOR EMERGENCY CARDIAC CARE


Assess Responsiveness

Unresponsive
Call for code team and Defibrillator
Assess breathing (open the airway,
look, listen and feel for breathing)

If Not Breathing,
give two slow breaths.
Assess Circulation

PULSE NO PULSE
Initiate CPR
Give oxygen by bag mask
Secure IV access If witnessed arrest, give
Determine probable etiology of arrest precordial thump and
based on history, physical exam, cardiac check pulse. If absent,
monitor, vital signs, and 12 lead ECG. continue CPR

Ventricular
fibrillation/tachycardia
(VT/VF) present on
monitor?
Hypotension/shock,
acute pulmonary
edema. NO YES
Go to fig 8
Intubate VT/VF
Confirm tube placement Go to Fig 2
Determine rhythm and
cause.
Arrhythmia

Bradycardia Tachycardia Electrical Activity?


Go to Fig 5 Go to Fig 6

YES NO

Pulseless electrical activity Asystole


Go to Fig 3 Go to Fig 4
Fig 1 - Algorithm for Adult Emergency Cardiac Care
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ALGORITHM FOR ASYSTOLE

Continue CPR. Confirm asystole by


repositioning paddles or by checking 2 leads.
Intubate and secure IV access.

Consider underlying cause, such as hypoxia,


hyperkalemia, hypokalemia, acidosis, drug
overdose, hypothermia. myocardial infarction.

Consider transcutaneous pacing (TCP)

Atropine 1 mg IV, repeat q3-5min up to a total of


0.04 mg/kg; may give via ET tube.

Consider bicarbonate 1 mEq/kg (1-2 amp) if


hyperkalemia, acidosis, tricyclic overdose.
Consider termination of efforts.

Fig 4 - Asystole
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