ADULT Cardiac Arrest (absence of a Palpable pulse) could be a bummer, Not for our Students.
1. Is a Defibrillator/AED available? If so, Use It.
Anytime a shock-able rhythm is present, It Should Be De-fibrillated.
2. On a, b. or c. Start CPR;
a. Immediately after the Defibrillation
b. If a non-shock-able rhythm is encountered
c. Defibrillator/AED is not available or inoperable
3. IV/IO Access; Give 200ml-500ml IV Bolus, as fast as you can get it in (60-90sec)
Fluids should be given by High volume infuser or using a pressure Bag, using 0.9NS.
Administration of fluids and Drugs should always be done during compression.
4. Administer 1mg/10ml Epinephrine every 3 minutes (the only clock you need to remember), better if done consecutively with Fluids.
5. By the 3rd Defibrillation if you still have a shock-able rhythm, consider Amiodarone before the 4th Defibrillation: May be repeated if shock-able rhythm persists.
a. 1st dose: 300mg/6ml IV Bolus
b. 2nd dose: 150mg/3ml IV Bolus
GOTO Step 2