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
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Maintain CPR approximately 2 minutes
→ IV/IO vascular access without interruption of CPR
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►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
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►Intubate with minimal interruption of CPR
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► 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
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►Defibrillate once at
Philips (150j)
Zoll (200j)
Lifepack (360j)
▼
For continued VF / pulseless VT:
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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
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For continued V-Fib or Pulseless V-Tach:
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→ 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
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►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