Adult Cardiac Arrest Algorithm
Note: This document provides a structured summary of the Adult Cardiac Arrest Algorithm for educational and reference purposes. It is not a substitute for certified ACLS training and adherence to the latest guidelines published by the American Heart Association (AHA) or other relevant governing bodies. Always consult the most current official guidelines.
1. Initial Steps
- Verify scene safety.
- Check for responsiveness and breathing.
- Activate emergency response system (call for help, get AED/defibrillator).
- Begin high-quality CPR immediately.
2. Assess Rhythm
- Attach monitor/defibrillator.
- Is the rhythm shockable (VF/pVT)?
Is Rhythm Shockable?
YES (Shockable: VF/pVT) – 3. If Shockable
- Shock 1: Defibrillate (Biphasic: Manufacturer recommendation, e.g., 120-200J; Monophasic: 360J).
- Immediately resume CPR for 2 minutes.
- Gain IV/IO access.
4. After 2 mins CPR (Shockable Rhythm)
- Assess rhythm. Is it still shockable?
Still Shockable?
YES – 5. If still Shockable
- Shock 2: Defibrillate.
- Immediately resume CPR for 2 minutes.
- Administer Epinephrine 1 mg IV/IO.
- Consider advanced airway and capnography.
- Assess rhythm. Is it still shockable? (If YES, go back to Step 5, consider Amiodarone/Lidocaine after Shock 3).
NO (ROSC)
Go to Post-Cardiac Arrest Care.
NO (Non-Shockable)
Go to Step 6.
NO (Non-Shockable: Asystole/PEA) – 6. If Non-Shockable
- Immediately resume CPR for 2 minutes.
- Gain IV/IO access.
- Administer Epinephrine 1 mg IV/IO.
- Consider advanced airway and capnography.
7. After 2 mins CPR (Non-Shockable Rhythm)
- Assess rhythm. Is it still non-shockable?
Still Non-Shockable?
YES
Go back to Step 6 (repeat Epinephrine every 3-5 mins).
NO (Shockable)
Go back to Step 3.
NO (ROSC)
Go to Post-Cardiac Arrest Care.
8. Throughout Cardiac Arrest
- Search for and treat reversible causes (H’s and T’s).
- Administer Epinephrine every 3-5 minutes during CPR.
- Consider Amiodarone (300mg bolus, then 150mg) or Lidocaine for refractory VF/pVT.
- Continuous chest compressions with ventilations every 6 seconds if advanced airway in place.