Adult ALS Algorithm

Question 1

Draw the ALS Adult Algorithm

Answer 1

See ALS manual pp. 3

Question 2

During ALS what must occur?

Answer 2

• Interventions during CPR
• Drugs
• Consider and Correct Reversible Causes

Question 3

What interventions should be performed during CPR as per the ALS Adult Algorithm?

Answer 3

• Airway adjuncts (LMA/ETT)
• Oxygen
• Waveform capnography
• IV/IO access
• Plan actions to minimise interruptions to compressions

Question 4

What drugs should be used during CPR as per the ALS Adult Algorithm?

Answer 4

• Shockable
• Adrenaline 1mg after 2nd shock then every 2nd loop (2, 4, 6…)
• Amiodarone 300mg after 3 shocks
• Non-shockable
• Adrenaline 1mg immediately then every 2nd loop (1, 3, 5…)

Question 5

If the patient is in a shockable rhythm when should adrenaline be given?

Answer 5

1mg after 2nd shock then every 2nd loop (2, 4, 6…)

Question 6

If the patient is in a non shockable rhythm when should adrenaline be given?

Answer 6

1mg immediately then every 2nd loop (1, 3, 5..)

Question 7

When should amiodarone be given?

Answer 7

After the 3rd shock

Question 8

List the reversible causes of cardiac arrest

Answer 8

• Hypoxia
• Hypovolaemia
• Hypo/ hyperkalaemia and metabolic disorders
• Hypo/ hyperthermia
• Tension pneumothorax
• Tamponade
• Toxins
• Thrombus (pulmonary/coronary)

Question 9

List interventions required during post resuscitation care?

Answer 9

• Re-evaluate ABCDE
• 12-lead ECG + repeat bloods
• Treat precipitating causes
• Aim for Spo2 94-98%, normocapnia and normoglycaemia
• Targeted temperature management