Adult Cardiac Arrest

BLS + rhythm check every 2 min. Shockable branch (VF/pVT) versus non-shockable (asystole/PEA).

START

Unresponsive, no pulse

ACTION

Start CPR

30:2 until airway. Compressions 100–120/min, depth ≥ 2 in (5 cm). Attach monitor/defibrillator.

DECIDE

Rhythm shockable?

SHOCK

Defibrillate

200 J biphasic (or per manufacturer). Resume CPR immediately for 2 min.

DRUG

Epinephrine 1 mg IV/IO

Repeat every 3–5 min. Consider advanced airway + capnography.

SHOCK

Shock, then CPR 2 min

After 2nd shock, add antiarrhythmic.

DRUG

Amiodarone 300 mg IV/IO

May repeat 150 mg once. Alternative: lidocaine 1–1.5 mg/kg. Treat reversible causes.

DRUG

Epinephrine 1 mg IV/IO ASAP

Repeat every 3–5 min. Continue high-quality CPR. Consider advanced airway.

NOTE

Treat reversible causes (Hs & Ts)

Hypovolemia, Hypoxia, H⁺ (acidosis), Hypo/hyperkalemia, Hypothermia · Tension pneumothorax, Tamponade, Toxins, Thrombosis (PE/MI).

END

ROSC → Post-arrest care

Optimize oxygenation, BP (MAP ≥ 65), 12-lead ECG, targeted temperature management.