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    9 views8 pages

    ACLS Algorithms 2020

    Uploaded by

    nelly aprilyani

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 8
    7 Adult Cardiac Arrest Algorithm CMe ee Tac American Heart Association. + 1wnoaceess CPR2 min + Epinephrine every 3-5 min + Consider advanced airway, ceapnography CPR2min + Amiodarone oF lidocaine @ + Ino signs of return of ( Start CPR Gwveoxygen Asystole/PEA | 1 Epinephrine ‘ASAP. CPR2 min + WwnOaccess + Epinephrine every 3-5:min Consider advanced airway, CPR2 min + Treatreversible causes spontaneous circulation (OSC) goto 10 or 1 ROSE, goto Post-Catda Arrest Care + Consider appropriateness 20-110 (14) 1SBN97B-1-61669-776- 10720, ‘of continued resuscitation Poshhoraltleast2inches [Bein et (100-120!) andallow compete chestrocol + Mima rterutionsin Compressors + Rrodescessve vetlaion + Ghangecompressoreveny | 2rmnates orsooneratques. | + Iino advanced away 302 + Gunttatve waveform capnegrapty SET lon or decreasing, reassess CPR aUal. | Fecommendstion(eg itis | ote of 120-200 Jeitankaown, | Uisemmximom vais. Secenandaubsequent doses shouldbe equivalent and higher Gosac ay ba conecored + Monophasie 360) a |. jabeeoseamae | eesrasas paiva coon a + Endoacheainbatonersu= | proglatte advanced.aiway + Waetomeapnogrey oan. Ertube plocemert + Once odvancesarweyinplacs, ‘vet broath every 6 seconds {totreatramiy wh contr uschesteonpressone Pnaea Cee) [+ Pucoandbioodpressue 1 abruptaustineanereasoln ered, ttypialy 240 mm) + Spontaneous arte pressure woes wth iva-teral Reversible Causes Hypovolemia Hypoxia Hyaregenion{acosish | f ypo-iyperalema { hiypetnerie G0t080r7 |S Tensionpneumomorax { Tomponte cae 1 Thrombosis puimonary 1 Thrombosis coronary erozanecnteatescton tra Bp Adult Post-Cardiac Arrest Care Algorithm (OMe Continued Management ‘and Adgitionat Emergent Activities ers Manage airway Early placement of endotracheal tube ‘Manage respiratory parameters ‘Start 10breaths/min *'$p0,92%-28% 35-45 mmHg Continus Consider for emergent cardiac intervention if + STEMI present + Unstable carcio enic shock. +1™ + ObtainbraincT Provide Hypovolemia Hypoxia Hypothermia Toxins American Heart Resuscitationis ongoing during the | post-ROSC phase, and many ofthese Activities can ocour concurrently. However. if prioritization is necessary follow these steps: + Airway management: Waveform capnograpiy or ceapnometry to confiem and monitor endotracheal tube placement Manage respiratory parameters: Tirate Fi, for Spo, 92%-98% start ‘at 10 breaths/min; tate to Paco, of Manage hemodynamic parameters: Agminister crystalloid andor vasopressor orinatrope for goal systolic blood pressure >90 mm Hg ormean arterial pressure >65 mmHg io cieiieuar oud ‘These evaluations should be done ‘concurrently so that decisions on targeted temperature management (TTM) receive high priority as ‘cardiac interventions, + Emergent carciac intervention: Early evaluation of 12-6ad lectrocardiogram ECG); consider hemodynamics for decision on cardiacintervention + TIME Ifpatientis not folowing commands, start TMas soonas possible: begin t 32-36°C for 24 hoursby using acooling device with feedbackloop + Other extical care management ~ Continuously monitor core temperature (esophageal rectal. bladder) ~ Maintain normoxia, normocapnia, euglycemia = Pravide continuous or intermittent tlectroencepnalogram (EC) ‘monitoring | tective ventilation Hydrogenion acidosis) Hypokalemia/hyperkalemia | Tension pneumothorax | Tamponade. cardiac Thrombosis, pulmonary Thrombosis, coronary Adult Tachycardia With a Pulse Algorithm eich ere es ead ‘Assess appropriateness for clinical condition. 21 hi Identify and treat underlying cause + Maintain patent airway:assist breathing as necessary + Oxygenlifhypoxemic} * Cardi ¥ Persistent tachyarrhythmia caus! + Hypotension? + Acutely altered mental status? + Signs of shock? Ischemic chest discomfort? + Acuteheart failure? 20-1110 (20f4) 'SON978-1-61659-776-1 ‘Synchronized cardioversion + Consider sedation + Adenosine only a American Heart Association. Doses/Details ‘Synchronized cardioversion: Refer to your specific device's recommended energy level to ‘maximize first shock success. ‘Adenosine V dose: First dose: 6 mg rapid IV push follow with NS flush. ‘Second dose: 12 mgifrequired. “Antiarrhythmic Infusions for Stable Wide-QRS Tachycardia Procainamide V dose: 20-50 mgimnin unt arrhythmia suppressed, hypotension ensues, ‘GRS duration increases >50%, or maximum dose 17 mg/kg given. Maintenance infusion: 1-4 mgimin, Avoid prolonged GT or CHF. ‘Amiodarone IV dose: First dose: 160mg aver 10 minutes. Repeat as neededif VT recurs, Follow by maintenance infusion of 1 mg/min for first hours. | sotalotiV dost | 100 mg 1.5 mg/kg) over 5 minutes. Avoid if prolonged QT. Ifrefractory, consider "= Underiying cause + Needtoincrease Consider rand 3 120 ©2020AmericonHeart Assocation PrintedintheUSA a Adult Bradycardia American Heart Algorithm Association. — ed PME ke ee ( Assessay ;ppropriatenes Identify and trest undertying cause + Maintain patentairway; assist breathing as necessary + Oxygen ifhypoxemic) saa a er igtuton antx boo Persistent bradyarrhythmia causin + Hypotension? + Acutely lteredmental status? * Signs of shock? | Atropine IV dost | First dose:1 mg bolus. Repeat every 35 minutes. Maximum: m9, Dopamine IV infusion: | Usualinfusion rates Ischemic chest discomfort? ‘Acute heart failure? eee 5-20 mog/kg per minute. Ifatropineinetfective: Titrate to patient response; ‘= Transcutaneous pacing taper stowly. Epinephrine IV infusion: 2-10meg per minute infusion. Titrate to patientresponse. Causes: ‘+ Myocardial ischemia infarction + Drugsitoxicologic (oa ccalcium-channal blockers, | beta blockers, digoxin) | + Hypoxia Electrolyte abnormality (e3: hyperkalemia) ‘©2020 AmercanHoar Association Acute Coronary American Heart Syndromes Algorithm Association. Eten kee eee aad EMS assessment and care and hospital preparation + Assess ABCs. Be preparedto provide CPRand defibilation ‘Administer aspicin and consider oxygen, ntogyeeri nc morphine needed IEC. ST levats Concurrent ED/eathiab assessment Immediate ED/eathiab general treatment {etominutes) 170, sat<90% strtonygenat mon trate : Seana rztenen | + hg einai oven) 1 Assess ASCa:ghwe oxygen needed ECG interpretation | STelevationornewor | ( Non-ST-elevation ACS (NSTE-ACS) presumably new LBEE: Determine iskuisingvaidated ‘strongly suspicious foriniury ‘score le TIMlor GRACE) ‘ST-elevation MI(STEM) ‘ Seo (ST depression or dynamic T-vave (NormaiEeGornonclagnostic | | ‘rversion, transient ST elevation, changes in ST segment or T wave strongly suspicious forischemia Towsisk score ‘andlor high-risk scare | Low-/intormodiate-risk NSTE-ACS (High-risk wsTE-acs ee

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