V fib-Defib
Pulseless Vtach
V Fib
Defibrillate
[Unsynchronized Shock]
1. Effective CPR
until defibrillator Arrives
(AED)
Minimize CPR interruptions:
Cycles of 30 chest compression: 2 Breaths
(Adult)
2. Check for Shockable Rhythm
3. Shock
if indicated
Single Shock
200J
4. Immediately restart CPR
2 minutes:
5 cycles of 30 chest: 2 Breaths
5. Check Rhythm
after 2 minutes CPR
6. If Rhythm, check for perfusing pulse
if pulse start supportive treatment
7. If no perfusing rhythm
give shock: 200J
[no shock for Pulseless Electric Activity]
(see PEA)
restart CPR
8. Give first drug during CPR
Typically 1 mg Epinephrine
IV
(Repeat EPI q 5 minutes)
9. Check Rhythm after 2 minutes CPR
10. If Rhythm, check for perfusing pulse
if pulse start supportive treatment: ROSC
11. If no perfusing rhythm (Not PEA)
give shock: 200J
restart CPR
12. Give second drug during CPR
Typically 300 mg Amiodarone IV
(Repeat dose of Amiodarone is 150 mg IV)
13. Check Rhythm after 2 minutes CPR
Repeat from Step 6
. . .
. . .
Lidocaine
If Amiodarone not available
Lidocaine 1 to 1.5 mg/kg
IV/IO
repeat 0.5 to 0.75 mg/kg q 5 to 10 minutes
Max Dose 3 mg/kg
Drip 1 to 4 mg/min
If no IV
2 to 4 mg/kg in endotracheal tube
Magnesium
1 to 2 gm IV for Torsades
