UAL

ALITYO SAETY
GAFETY&

ED
STER

CHRISTIAN MEDICAL cOLLEGE, VELLORE

OFFICE OF THE NURSING SUPERINTENDENT
ADULT CARDIAC ARREST ALGORITHM NABH NABH
AcCRED URSIN

Adult Cardiac Arrest Circular Algorithm CPR Quality

Push hard (at least 2 inches
[5 cm]1) and fast (100-120/min)
allow complete c h e s t recoil.
and
Minimize i n t e r r u p t i o n s in
compressions.
Avoid excessive ventilation.
Change compressor every
2 minutes, or sooner if fatigued.
If no a d v a n c e d airway, 30:2
compression-ventilation ratio,
or 1 breath every 6 seconds.
Quantitative vwaveform
Give Start CPR
Give oxygen capnographyy
- i f PETCO, is low ordecreasing
Attach monitor/defibrillator reassess CPRquality.
Shock Energy for Defibrillatioon
2 minutes Return of Spontaneous
Circulation (ROSC) Biphasic: Manufacturer
r e c o m m e n d a t i o n (eg, initial
dose of 120-2oo J); if unknown.
Check Post-Cardiac u s e maximum available.
Rhythm Arrest Care Second and subsequent doses
If VF/pVT should be equivalent, a n d higher
Shock doses may be considered.
Monophasic: 360 J

Drug Therapy Drug Therapyy

VIIO access
Epinephrine every 3-5 minutes Epinephrine IV/IO dose:
Amiodarone or lidocaine 1mg every3-5 minutes
AmiodaronelV/lO dose:
for refractory VF/pVT First dose: 300 mg bolus.
Second dose: 150 mg.
Consider Advanced Airway or
Lidocaine lVIIO dose:
Quantitative waveform capnography

ugo
First dose: 1-1.5 ng/kg.
Second dose: O.5-0.75 mg/kg.

Treat Reversible Causes

ICPR Advanced Airway
Endotracheal intubation or
su
praglottic advanced airway
Waveform
apnography o r cap-
Monitor CPR uality nometry to confirm andmonitor
ET tube placement
Once advanced airway
give 1 b r e a t h e v e r y 6
in
s e c oplaCe
nds
(10 breaths/min) with continu-
o u s chhest c o m p r e s s i o n s

Return of Spontaneous
Circulation (ROSC)
Pulse and blood pressure
Abrupt sustained increase in
PETCO, (typically 240 mm Hg)
Spontaneous arterialpressuré
waves with intra-arterla
monitoring
Reversible Gauses
Hypovolemia
Hypoxla
Hydrogen lon (acidosis)
2020 Amerlcan Heart Assoclation ypo-/hyperkalemia
Hypothermla
Tensionpneumothorax
Tanmponade, cardiac
Toxins
Thrombosis, pulmonary
T h r o m b o l s , cOronary