The document outlines the protocol for adult cardiac arrest response, emphasizing the rapid establishment of unresponsiveness and the immediate need for CPR and defibrillation in cases of shockable rhythms. It details the steps to be taken in a systematic approach, including medication administration and treatment of reversible causes, while maintaining high-quality compressions and minimizing interruptions. Key medications and their dosages, as well as the importance of monitoring and advanced airway management, are also highlighted.

1. Adult Cardiac Arrest
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High-Quality CPR
Defibrillation Energy
Biphasic:
Manufacturer-recommended Dose
Monophasic:
360 J
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1 Establish
Unresponsiveness
3 Shockable
rhythm?
5 Vfib or Vtach
Administer defibrillation
_
Compression rate 100/min
Compress chest to depth of at least
2 inches
Allow for complete chest recoil
Minimize interruptions
Avoid hyperventilation
Rotate compressor every 2 min to
prevent fatigue
2 Call Code/Activate EMS
Immediately begin CPR
Administer oxygen if available
Attach monitor/defibrillator,
establish rhythm
7 Immediately resume CPR
for 2 min
Establish vascular access
8 Shockable
rhythm?
10
Yes
Administer
defibrillation
12 Immediately resume CPR
for 2 min
Administer Epinephrine
every 3-5 min
Consider advanced airway,
ET CO2 Monitoring
14 Shockable
rhythm?
16
Yes
Administer
defibrillation
18 Immediately resume CPR
for 2 min
Administer Amiodarone
Establish and treat
reversible causes
No
No
4 PEA/Asystole
9 Shockable
rhythm?
No
13 Shockable
rhythm?
17
No
Go to 10
or 16
Go to ROSC
Algorithm
6 Immediately resume CPR
for 2 min
Establish vascular access
Administer Epinephrine
every 3-5 min
Consider advanced airway,
ET CO2 Monitoring
11 Immediately resume CPR
for 2 min
Establish and treat
reversible causes
15 ROSC? Yes
No
No
Yes
Yes
Epinephrine
1 mg every 3-5 min
May replace 1st or 2nd dose with:
Vasopressin
40 units IV Push
Amiodarone
1st dose: 300 mg bolus
2nd dose: 150 mg
H’s and T’s:
Hypoxia
Hypovolemia
Hydrogen Ion (Acidosis)
Hypo/Hyperkalemia
Hypothermia
Toxins
Tamponade (cardiac)
Tension Pneumothorax
Thrombosis (coronary and pulmonary)
Trauma