Adult Cardiac Arrest Circular Algorithm

Adult Cardiac Arrest Circular Algorithm

The Adult Cardiac Arrest Circular Algorithm illustrates how the process of CPR is CONTINUOUS, and should only be interrupted for brief rhythm checks lasting 5-10 seconds.
The GOALS  of this continual process is:

  1. Early identification of cardiac arrest
  2. Quality CPR (PUSH HARD AND FAST) without interruptions. 
  3. Early defibrillation

CPR should:

  1. Administer 100-120 compressions / minute
  2. Allow complete chest recoil
  3. Not be interrupted
  4. Avoid excessive ventilations
  5. Include 30:2 compression / ventilation ratio
  6. Include waveform capnography to assess effectiveness of CPR

In terms of defibrillation:

  1. Administer early
  2. If biphasic, administer 120 – 200 Joules.
  3. If monophasic, administer 360 Joules.

In terms of medication:

  1. Epinephrine every 3-5 minutes
  2. Amiodarone or lidocaine for refractory V fib or pulseless V tac

In terms of advanced airway:

  1. Endotracheal tube or supraglottic airway (LMA)
  2. Waveform capnography to monitor endotracheal tube placement
  3. One advanced airway in place, give 1 breath every 6 seconds with continuous compressions

In terms of ROSC:

  1. Check pulse and blood pressure
  2. End tidal CO2 will increase (>40 mm Hg)
  3. Intra-arterial monitoring will show pressure wave

In terms of Reversible causes of cardiac arrest:

  1. Consider 5 H’s and 5 T’s and treat to prevent patient from reentering cardiac arrest

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