1. Initiate CPR.

2. Mandatory interventions:

a. Endotracheal intubation or adjunct airway insertion

b. IV/IO access

c. Cardiac monitoring

3. Assess EKG rhythm.

VENTRICULAR FIBRILLATION / PULSELESS V-TACH

1. Defibrillate at 2 J/kg.

2. Resume CPR for 2 minutes immediately after defibrillation.

3. Administer EPINEPHRINE 1:10,000 0.01 mg/kg (0.1 mL/kg) IV/IO. If no IV/IO access, give via ETT at 2 ½ times above dose. Administer epinephrine every 3 – 5 minutes as needed.

4. If VF/VT continues:

a. Re-attempt defibrillation at 2 – 4 J/kg.

b. Administer LIDOCAINE 1 mg/kg IV/IO. May repeat every 5 minutes (maximum 3 mg/kg).

5. Continue CPR and DEFIBRILLATION – EPINEPHRINE – LIDOCAINE sequence until ROSC or arrival at medical facility.

ASYSTOLE / PULSELESS ELECTRICAL ACTIVITY

1. Administer EPINEPHRINE 1:10,000 0.01 mg/kg (0.1 mL/kg) IV/IO every 3 – 5 minutes as needed.

2. Continue CPR and epinephrine sequence until ROSC or arrival at medical facility.