Updates AHA 2015 and AHA 2020

1. Epinephrine could be given ASAP in non-shockable rhythm

2. Chain of survival has become 6 steps
3. Detailed management of cardiac arrest in pregnancy
4. Separate section of management of cardiac arrest in pediatrics
5. Additional algorithms in ROSC

 CPR quality
Push hard (5 cm) and fast (100-120/min) and allow complete chest recoil.
Change compressor every 2 minutes or sooner if fatigue.
If no advanced airway, 30:2 compression-ventilation ratio.


IHCA : In-Hospital Cardiac Arrest ; OHCA : Out-Hospital Cardiac Arrest

 Cardiac Arrest Algorithm

Shockable : Pulseless VT & VF
Non-shockable : Asystole & PEA
 Intubate the patient after first cycle on non-shockable rhythm.
(CPR while you prepare first epinephrine  (if epinephrine ready) assess rhythm  if
rhythm is non-shockable, then give epinephrine ASAP and continue CPR (1 cycle)  Do
endotracheal intubation)

 Follow up reversible causes : 5Hs and 5Ts

TTM : Targeted Temperature Management
Cardiac Arrest in Pregnancy In-Hospital ACLS Algorithm
* Uterus can pushed Inferior Vena Cava, tilt the body to release IVC pressure.