ADULT

V-Fib or Pulseless V-Tach / Wide Complex Tach

Algorithm

New UPDATED 4/1/2019

Initiate or continue CPR and when defibrillator available:

Defibrillate once at

Philips (150j)

Zoll (120j)

Lifepack (200j)

Apply Automatic Chest Compression device when available before movement


Maintain CPR approximately 2 minutes
→ IV/IO vascular access without interruption of CPR


Defibrillate once at

Philips (150j) 

Zoll (150j)

Lifepack (300j)


Maintain CPR 2 min

Epinephrine 1 mg IV / IO (0.1 mg /1mL), approximately every 3 minutes

Intubate with minimal interruption of CPR

Defibrillate once at

Philips (150j)

Zoll (200j)

Lifepack (360j)


Maintain CPR 2 min

Amiodarone 300 mg IV / IO, may repeat 150 mg IV / IO in 3 minutes

Defibrillate once at

Philips (150j)

Zoll (200j)

Lifepack (360j)

For continued VF / pulseless VT:

RETURN OF SPONTANEOUS CIRCULATION (ROSC)
If prior to transport the pt develops a rhythm with pulse:
Make BHC for possible transport to Cardiovascular Receiving Center (CVRC)

 → Assess for and correct suspected:

Hypoxia, Hypovolemia, Hypoglycemia, and Hypothermia


For continued V-Fib or Pulseless V-Tach:

→ Maintain CPR and transport to nearest PRC or make Base contact to: Provide further resuscitation orders - If If appropriate, request pronouncement of patient in the field

D10 25 gm/250 mL (10% solution) IVPB / IO

If diabetic and hypoglycemia suspected:
(No D-stick, Non-Traumatic FA)

Epinephrine can be given with D10, there is no negative reaction

 

Interruption of chest compressions should always be held to a minimum.
Pads can be placed in the antero-lateral and antero-posterior positions;
For implanted pacemaker/defibrillator place pads to either side and not directly on top of the implanted device. For medication patch: remove patch, wipe area clean before attaching an electrode pad.

 

1:10,000 = 0.1mg/mL

1:1000 = 1mg/mL

Call

M: 949-769-1162

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