Adult Advanced Life Support

Question 1

Adult advanced life support

(1)

Answer 1

• ratio of chest compressions to ventilation is 30:2
• chest compressions are now continued while a defibrillator is charged
• during a VF/VT cardiac arrest, adrenaline 1 mg is given once chest compressions have restarted after the third shock and then every 3-5 minutes (during alternate cycles of CPR).
• atropine is no longer recommended for routine use in asystole or pulseless electrical activity (PEA).
• a single shock for VF/pulseless VT followed by 2 minutes of CPR, rather than a series of 3 shocks followed by 1 minute of CPR

Question 2

Adult advanced life support

(2)

Answer 2

• if the cardiac arrested is witnessed in a monitored patient (e.g. in a coronary care unit) then the 2015 guidelines recommend ‘up to three quick successive (stacked) shocks’, rather than 1 shock followed by CPR
• asystole/pulseless-electrical activity should be treated with 2 minutes of CPR prior to reassessment of the rhythm
• delivery of drugs via a tracheal tube is no longer recommended
• following successful resuscitation oxygen should be titrated to achieve saturations of 94-98%. This is to address the potential harm caused by hyperoxaemia