The Cardiac Arrest Algorithm takes its place as the most important algorithm in the ACLS Protocol. There are 4 rhythms that are seen with pulseless cardiac arrest. They each will be reviewed throughout this section of the course guide. These four rhythms are pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).
Click below to view the cardiac arrest algorithm diagram. When done click again to close the diagram.
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Cardiac Arrest Diagram
The majority of patients that experience sudden cardiac arrest will be treated with the Cardiac Arrest Algorithm. Therefore, mastery of this algorithm is very important. There are 2 branches of the Cardiac Arrest Algorithm, the left, and right branch.
The LEFT BRANCH is used for the treatment of pulseless ventricular tachycardia and ventricular fibrillation,and the RIGHT BRANCH is used for the treatment of PEA and Asystole.
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Watch Part 1 and Part 2 of the Cardiac Arrest Video Review.
Within ACLS Protocol, there is also a Simplified Cardiac Arrest Algorithm that simplifies and streamlines uncomplicated cardiac arrest. Use this link to watch a short video that reviews the 2015 Simplified Cardiac Arrest Algorithm.
Top Questions Asked on This Page
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Q: Can precordial thump still be used for witnessed arrest?
A: This is the AHA position and it has not changed since 2010. “The precordial thump may be considered for termination of witnessed monitored unstable ventricular tachyarrhythmias when a defibrillator is no immediately ready for use, but should not delay CPR and shock delivery. There is insufficient evidence to recommend for or against the use of the precordial thump for witnessed onset of asystole.
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Q: How fast do you push the Amiodarone 300mg?
A: In a cardiac emergency, you will push amiodarone as fast as you can push the plunder of the syringe. Essentially the same as you would push any drug in a cardiac emergency.
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Q: I keep getting confused about when to return to administration of epinephrine following the initial dose and admin of 300/150 amiodarone…is it based on time (q 3-5 min)? Any suggestions on how to keep this straight?
A: After the first dose of epinephrine, it is essentially on its own time table. Just remember to give epinephrine every 3-5 minutes after the first dose. Amiodarone is given after the 3rd (300mg) shock and any time after 4th (150mg) shock.
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Q: If you give precordial thump, is it given just once?
A: Yes, the precordial thump is attempted only one time. it is effective only if used near the onset of VF or pulseless VT, and so should be used only when the arrest is witnessed or monitored and only at the outset. . About 25% of patients in cardiac arrest who received a thump on the precordium regained cardiac function according to one study. There is no evidence that the precordial thump improves recovery in unwitnessed cardiac arrest.
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