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ACLS Adult Cardiac Arrest Algorithm
Determine if the patient is Stable or Unstable.
Initiate CABD and Secondary ABCD.
Use appropriate ACLS algorithm.
Generally accepted treatments: “MONA”: Morphine, Oxygen, Nitrates, and Aspirin
Consider fibrinolytic therapy.
ACLS Adult Tachycardia with a Pulse
Determine if the patient is Stable or Unstable.
Initiate CABD and Secondary ABCD.
Attempt vagal maneuvers.
first line Rx is: Adenosine 1st dose: 6mg IV then 2nd and 3rd doses: 12mg IV
Other Rx options include: Diltiazem and Beta blockers
Rx options include: Diltiazem and Beta blockers
Sedate the patient and provide cardioversion.
Tx Atrial Fibrillation: first shock 100-200j
Tx Atrial flutter and SVT: first shock 50-100j
Ventricular Tachycardia (monomorphic):
Sedate the patient and provide cardioversion.
Amiodarone 150mg IV over 10 min every 3-5 min, with a max of
2.2g in a 24hrs period.
Procainamide 20 to 50 mg/min IV until arrhythmia resolves, hypotension occurs, there is >50% increase in QRS duration, or the max dose of 17 mg/kg is reached (Maintenance infusion: 1 to 4 mg/min)
Sotalol 1.5 mg/kg over 5 min
Procainamide and sotalol should be avoided in patients with prolonged QT.
SupraVentricular Tachycardia (SVT) with Aberrancy:
Adenosine 1st dose: 6mg IV then 2nd and 3rd doses: 12mg IV.
Atrial Fibrillation with Aberrancy:
Rx options include: Cardizem, Beta Blockers
Atrial Fibrillation with Wolff Parkinson White (delta wave):
Avoid!!!: adenosine, verapamil, cardizem, and digoxin.
Give Amiodarone 150mg IV over 10 min
Toursades de Pointes:
Give magnesium 1 to 2g IV over 2 min