Advanced Life Support for Adults

During CPR
Start CPR Airway adjuncts (LMA / ETT)
30 compressions : 2 breaths CA'l ~ - Oxygen
Minimise Interruptions 7 Mi; Waveform capnography
0 u4-f- -) WCfat/-
7 IV / 10 access
i'nr(eq-i Plan actions before interrupting compressions
Attach kt\(,lt ~,..~ (e.g. charge manual defibrillator)
Defibrillator I Monitor i i\5e,.;htJY1 eJitAylv¼1 Drugs
Shockab/e
* Adrenaline 1 mg after 2nd shock
(then every 2nd loop)
• Amiodarone 300mg after 3 shocks
Assess Rhythm Non Shockable
• Adrenaline 1 mg immed iately
...j- (then e110ry 2.cLd loop)
Non Consi
Shockable Hypoxia
Shockable
Hypovolaemia
Hyper/ hypokalaemia / metabolic disorders
Return of Hypothermia / hyperthermia
Shock Spontaneous Tension pneumothorax •
Circulation? Tamponade .
Toxins
Thrombosis (pulmonary I coronary)
CPR CPR
for 2 minutes for 2 minutes Post Resuscitation Care
Re-evaluate ABCDE
12 lead ECG
Treat precipitating causes
Aim for: SpO2 94-98% , normocapnia and
[ Post Resuscitation Care J normoglycaemia
Targeted temperature management
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Assess for:
Upper airway obstruction
(strider, oral swelling)
or
Lower airway obstruction
(wheeze, respiratory distress)
or
Shock
.
•
(dizziness, pale, clammy)
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Call for help
Remove trigger I causative agent
Position flat or sitting, not walking or standing .

NO
•
-----1(Cardiac arrest?)1---- ves
Adrenaline IM
Refer Advanced Life
Use auto injector if available
Support algorithm
(pre,fel:Jcee--iflit.~~.ile-.UIJI.Jet...cuterthigh)
dults: 0.5mg (0.5ml of 1:1,000
Children: 10mcglkg (0.01ml/kg of 1:1,000)
(min dose 0.1ml, max dose 0.5ml)
Repeat every 5 minutes as needed

Attach cardiac monitoring

High flow oxygen Observe (4 hours min)
IV access
( RESOLUTION }+ Monitor vital signs, reassess ABC
For shock:
0.9% saline rapid infusion Consider steroids and oral
Adults: 1,000ml antihistamine
Children: 20ml/kg

Call for speclallst advice

Consider:
• Transfer to advanced care setting • Adrenaline infusion
• Further 0.9% saline • lnotropic support
• Nebulised adrenaline for upper • Nebulised salbutamol for lower
airway obstruction airway obstruction

January 2019
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