BLS Healthcare Provider Adult Cardiac Arrest Algorithm for Suspected or Confirmed COVID-19 Patients pated Apri 2020 \Verify scene safety }on PPE Victims unresponsive. Shoutfornearby help. Sena eae ene ‘Activate emergency response system sing bag-mask device with via mobile device if appropriate. Cont TiAnicSSal a GetAED and emergency equipment ~ Tbreath every 5-6 seconds, (orsend someone to do so. Dee RO eon + Activate emergency re- Nonormal | sponsesystem (ifnot already breathing, | done)after2minutes. ‘oronlygaspingandcheck \\ haspulse | * Continue rescue breathing: pulse (simuttaneously) check pulse aboutevery Is pulse definitely felt 2 minutes. fo pulse, begin within 10 seconds? CPR (go to "CPR" box, + If possible opicid overdose, administer naloxone if available per protocol. Normal breathing, has pulse Look for no breathing Monitor until emergency By this time inall scenarios, emergency response system or backup is activated, and AED and emergency equipment are retrieved or someone is retrieving them. Begin cycles of 30 compressions and 2 breaths using bag-mask device with filter and tight seal ‘OR continuous compressions with passive ‘oxygenation using face mask. Use AEDas soonasitls avaiable. AED arrives. Checkrhythm. Shockablerhythm? ~*~ No, nonshockable Give 1 shock. Resume CPR Resume CPR immediately for immediately for about2 minutes about 2 minutes (untilprompted {unt prompted by AED to allow by AED to allow rhythm check). rhythm check). Continue until ALS providers take Continue until ALS providers take ‘over or victim starts to move. over or victim startstomove. (© 2020 American Heart AssocationACLS Cardiac Arrest Algorithm for Suspected or Confirmed COVID-19 Patients Upstedteri202 oy \FipvT ‘Asystole/PEA (Somenatast( 00-120") lndatow compet chest eco + Mtnintzeinteruptonsin| + Bonifoweessvovertlaton + henge compressor avery Sranies or aooner angus + Hroadvanees arn 302 ‘Compression vortiation ate + Guantatie nvetorm Shoat Appr, <10 mm stem {cinoma = iielaationphase laste) Pressure cbrrntigattampt TeimprovecPRauaty {ose of 120-200 J furkown, ‘eemanrum aatabe ‘Secondandsubsequon’ dss Shoutdbeeauvaton ander Sosesrray decorated, + Monophase 560 CPR2min + no access: CPR2min + Epinephrine every 2-Smin + Consider mechanical ‘compression device Ino signs of return of spantanaous Gotosor7 ‘erculaton ROSG, goto 1or 11 \ } IfROSC, go toPost-Cardiae Arrest Care + Sar vaeotyagscony Supragote advanced away + hieomespragapny {obrestnsmon wth cononveus * EpinaprnelV/I0 dose ‘Sone 200m boli Second (oon 190mg Ftc: mgheg Second ooei0-075mghg nos ee + Puseandbleodpressize { Abrptsustamedinereeso mn etc, typialy =t0 mm + Spentaneousartnal pressure * Hypovoemie| ipo 1 Hrdrogenon eto 1 Hine mypertaems { Myponrma ‘Thomboas exonsBLS Healthcare Provider Pediatric Cardiac Arrest Algorithm for the Single Rescuer for Suspected or Confirmed COVID-19 Patients ptt i020 \Vietimis unresponsive. ‘Shout fornearby help. ‘Activate emergency response system ‘via mobile device (if appropriate). ‘Look forno breathing cr only gasping and check pulse (simultaneously, Ispulsedefinitely felt ‘within 10 seconds? CPR ‘rescuer: Begin cycles of ‘30 compressions and 2 breaths using bag-mask device with filter and tight seal. (Use 15:2 ratio if second rescuer arrives) Use AED as soonasitis available. After about 2minutes, f stil alone, activate ‘emergency response system and retrieve AED {ifnotalready done}. Give 1 shock. Resume CPR Immediately for about 2minutes (until prompted by AED to allow Thythm check). Continue until ALS providers take ‘over or victim starts to move. Resume CPR immediately for about 2:minutes (until prompted by AED to allow rhythm check) Continue until ALS providers take over or victim starts to move. (©2020 American Heart AssociatonBLS Healthcare Provider Pediatric Cardiac Arrest Algorithm for 2 or More Rescuers for Suspected or Confirmed COVID-19 Patients LUpdiotea Ave! 2020 Vietim is unresponsive. Shout for nearby help. Firstrescuer remains with victim, ‘Second rescuer activates emergency response system andretrieves AED + Provide rescue breathing ‘and emergency equipment. using bag-mask device with A filter and tight seal. + I breath every 3-5 seconds, Normal Nonormal | orabout 12-20breaths/min. breathing, _/ Lookfornobreathing \. breathing, | + Add compressionsif pulse has pulse / oronly gaspingandcheck \. has pulse | remains <60/minwith signs of. pulse (simultaneously). [poor perfusion. 's pulse definitely felt + Activate emergency response vithin 10 seconds? system (ifnot already done} after 2 minutes. Nobreathing + Continue rescue breathing: or only gasping, ccheck pulse aboutevery no pute 2minutes. fo pulse, begin CPR(goto “CPR” box). CPR Firstrescuer begins CPRwith 30:2 ratio (compressions to breaths) using bag-mask device with filter and tight seal. When secondrescuer returns, use 18:2 ratio (compressions tobreaths). Use AEDas soonas itis available. ‘AED analyzes rhythm, Shockable rhythm? Give 1 shock. Resume CPR No, nonshockable Resume CPR immediately for immediately for about 2 minutes ‘about 2 minutes (unti prompted {until prompted by AED toallow by AED to allow rhythm check). rhythm check). Continue until ALS providers take Continue until ALS providers take over or victim starts tomove. over or victim starts to move.Pediatric Cardiac Arrest Algorithm for Suspected or Confirmed COVID-19 Patients patente 2020 A Start CPR + Ventilate with oxygen using bag-mask device with filter ‘and tight seal, if unavailable use nonbreathing face mask + Attach monitoridefirilator + Propareto intubato vFipvT ‘Asystole/PEA =e + Epinephrine every 3-5 min CPR2min Treat reversible causes Rhythm shockable? CPR2min + Amiodarone or lidocaine + Treat reversible causes ifno signs of return of spontaneous. [ Gotosor7 irculation ROSC), goto 10 or 11 \ + IfROSC, go to Post-Cardiac Arrest Care (©2020 American Haart Association Pushhard sof anteroposterior ameter of chest anda {100-120/mirdandatlow complete chest reco. + Minimize interruptions compressions. ‘void excessive vent Change compressor 2minutes, oF sooner fatigued, + Ifnoadvanced away, 15:2compreasion-ventiaton ratio Ecnens First shock? tka. second shock 4ikg subsequent shocks 24 Jkg, ‘maximum 10 kg or adult dose Use intubator with highest likeinood of fist pase success Consider video laryngoscopy + Endotrachealintubation or upraglotic advanced alway + Waveform capnography or capnometrytcontirmand rmontor Ttubeplacement Onceadvancedairwayinplace, (ve 1 breath every seconds {HObreathsimin) with continuous chest compressions + Epinephrine lO/1V dose: LOT mg/kg (04 mLiAg of the 0:1 maim concentration, Repost every 3-5minutes. + Amiodarone O/IV dose: Smaykg bolus duringcardlacarrest. May repeat upto 2tImes for rettac- toryVpulseless VT. Lidocaine 1orv dose: Inst Tmgfkgioading dose. Maintenance! 20-50 moar per minute nusion repeat bolus dose iefusionntated>18 minutesattor nil bos therapy cece 2) + Pulse and blood pressure + Spontaneous arterial pressure waves with inta-artelal rmonorng * Hypovolemia + Hyponia 4 Hyerogenion acidosis) + Hypoaiyeemis + Hypo-Myperkalemia * Hypothermia «Tension preumothorax + Tamponade, cardiac Toxins * Thrombosis, pulmonary + Thrombosis,coranary