Adult and Pediatric Cardiac Arrest Administrative Guideline Flashcards
Initial step
Initiate chest compressions at rate of 100-120 bpm
Immediate rhythm check/defibrillation 2 J/kg (200 J adult dose)
15 LPM NRB mask & NPA/OPA + NC 10 LPM
If non-cardiac etiology (e.g. respiratory
causes, pediatric) -
IMMEDIATELY begin airway management and positive pressure ventilation. Ventilation Rates: Adults - 10 bpm Peds 12-20 bpm Ventilate all children < 8yo using BVM only
Minutes 1-8
- Perform 4 rounds of 200 compressions
- Check rhythm and pulse every 2 minutes
- Defibrillate if indicated
- Minimize interruptions
-IV/IO access
-Administer epinephrine as early as possible
-If VT/VF after first shock, administer amiodarone or lidocaine
For polymorphic VT (torsades) administer magnesium.
Consider alterative etiologies
Hyperkalemia: Calcium chloride Hypovolemia/Shock: NS fluid bolus Suspected opioid overdose: Naloxone Hypoglycemia: Hypoglycemia AG Torsades: Magnesium
Minutes 8-20
Place advanced airway (supraglottic airway or ETI)
after 4 rounds/8 minutes
Administer 2nd dose of epinephrine
P
ROSC at any time
YES?
Post ROSC AG
ROSC at any time
NO?
Dead on Scene AG
Defib joules
2 J/kg –> 4 J/kg –> 6 J/kg –> 10 J/kg (Max 200J)
Epi dosages
(1 mg/10mL) 0.01 mg/kg IV/IO (max dose 1 mg)
Max total dose of 2mg with 2nd dose at 8 minutes
Amiodarone dosages
5 mg/kg IV/IO. Max dose 300 mg
May repeat x 1 at 2.5 mg/kg I/IO. Max dose for repeat is 150 mg
Follow amiodarone doses with 20 mL NS flush
Do not administer in torsades
Lidocaine dosages
1mg/kg (max dose 100 mg) IV/IO.
May repeat x 1 at 0.5 mg/kg (max dose (50 mg)
Naloxone for opioid overdose concert
2 mg IN/IV/IO
May repeat naloxone 2 mg IV/IO
If there is a concern for hyperkalemia
Administer calcium chloride 20 mg/kg IV/IO
Max dose 1 g
For polymorphic ventricular tachycardia
Administer magnesium 25 mg/kg (max 2g) IV/IO over 2-5 minutes.
Where is hyperkalemia often seen?
renal failure, tissue destruction (such as prolonged downtime from rhabdomyolysis or large burns), certain medications, or prior episodes of hyperkalemia, and should be suspected in wide complex rhythms or VF.
