![]() Fatigue generally results in insufficient compressions and perfusion may be affected. Some important points to remember about resuscitation for asystole or pulseless electrical activity include:įirst, change compressors about every 2 minutes or sooner if the individual providing compressions becomes fatigued. You should consider an advanced airway and capnography at this point as well.Ĭontinue to give epinephrine every 3 to 5 minutes if necessary, and alternate 2 minutes of CPR with 10-second rhythm checks because a non-shockable rhythm may convert to a shockable rhythm, or there may be a return of spontaneous circulation (ROSC). This may require establishing intravenous or intraosseous access. Once a non-shockable rhythm has been identified, it is critical to administer 1 milligram of epinephrine intravenously or intraosseously as soon as possible, while CPR continues. This is also referred to as electromechanical dissociation.īoth of these rhythms are considered non-shockable because they indicate that the muscle of the heart is not functioning properly, and therefore would not respond to defibrillation. With pulseless electrical activity, the tracing will show electrical activity but the mechanical functioning of the heart is not adequate to produce a pulse. We sometimes say that a patient has “flatlined.” On an electrocardiogram or monitor, asystole is characterized by a flat line, which indicates that both electrical and mechanical activities of the heart have stopped. Let’s look first at interventions for non-shockable rhythms. For this reason, pulse checks should always be done in conjunction with rhythm checks. PEA is characterized by a readable rhythm on the monitor, but no palpable peripheral pulse. Non-shockable rhythms include asystole and pulseless electrical activity, or PEA. Shockable rhythms include ventricular fibrillation and pulseless ventricular tachycardia. CPR should be paused for no more than 10 seconds to assess the patient’s rhythm. Next, while CPR continues, attach the monitor/defibrillator if it’s not already in place and conduct a rhythm check to determine if the rhythm is shockable or non-shockable. If and when an airway is established, oxygen should be administered at a concentration of 100%. In some cases, others may already have started CPR, but as the medically trained professional, you should relieve them.ĬPR should be administered at 30 compressions to 2 ventilations until an airway is established, compressing to a depth of about 2 inches at a rate of 100 to 120 beats per minute. Under the cardiac arrest algorithm, the first step is to begin CPR. ![]() ![]() We will review protocol for responding to cardiac arrest (both non-shockable rhythms and shockable rhythms) and symptomatic bradycardia during this video.Īdvanced adult cardiac life support is carried out by medical personnel, such as paramedics, doctors, and nurses, with the appropriate training and access to medications and resuscitation equipment. Welcome to this video on advanced adult cardiac life support, or ACLS, based on the American Heart Association’s algorithms. ![]()
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