PEA= no

pulse=
CPR

PEA best
described
as
SinusRhyt

hm without
pulse

Asytsole
for

awhile=co
nsider
terminating
efforts

Start with
basics
first(ABC
s)

Unconscio
us pt with
rhythmon
monitorfirst

priority
isdetermin
e if there is
a pulse

Purpose of
Rapid
ResponseT
eam is to
identify &

treatearly
clinical
deterioratio
n

Pt with
epigastric
pain=STAT
EKG rule
out

MI ______
_________
_________
_____

Capnogra
phy
(PETCo2)

Device
placed
between
ET tube
and ambu

and hooked
to monitor

Measures
amount

Co2
exhaled by
ptwaveform
will

increase
when pt
exhales

Measure
effectivene
ss if chest
compressio
ns

Measures
adequate
coronary
perfusion

Best
indicator of
ET tube
placement

ROSC(retu
rn of
spontaneou
s

circulation)
- target
Co2 level
is 35-40

During ET
suctioning
withdraw
no longer
than 10 sec

Avoid
anchoring
ET tube
with ties

around
neck- if too
tight can
obstruct

venousretu
rn to brain
Return of
Spontaneo
us

Circulatio
n (ROSC)

Pt gets

therapeuti
c
hypother
mia
protocol

which
lowers
their body
tempin
order to

help
reduce the
risk of
ischemic
injury to

tissue &
brainfollo
wing a
period of

insufficient
blood flow

Goal-i.

Cool for 24
hours to
goal temp
of 89-93 F

Contraindi
cationi.
pt
responding

to verbal
commandsi
i.

Known
pregnancyi
ii.
DNRiv.

Recent
head
trauma or

traumatic
arrestv.
In coma
from other

causes like;
overdose,
stroke,
etcvi.

Temp
already
less than
93.2 F

Indications
:i.
Unresponsi
ve pt not

responding
to
commands
after
ROSCii.

Estimated
time from
arrest to
ROSC is

less than
60 minutes

If
hypotensiv

e with
ROSC= 12 liters of
NS or LR
to keep

minimums
ystolic
pressure of
90

1
st

priority in
ROSC pt is
to optimize

ventilation
and oxygen
ation

Cardiac
Arrest-

Non
Shockabl
eAlgorit
hm

(PEA/As
ystole)
Start
continuous

CPR, call
EMS/code,
ApplyO2,
Attach

monitor/de
fibrillator

Monitor
Shows

Asystole or
PEA

CPR,
IV/IO

Epinephri
ne 1 mg IV
every 3-5
min. &

Airwaywit
h
Capnograp
hy

TreatCaus
es

Non
symptomat

ic stable
SVTdo
EKG 1
st

before
meds

D
efib=

D
ead=200 J>V fib
&Vtachno pulse

Synch
C
ardioversio
n=

C
rashingSVT Vach
with pulse

Bradyc
ardia
Algorit
hm

Assess
Clinical
Condition:
HR <50,

B/P,
Skincolor,
LOC, Pain,
Dizziness,

Identify
Treatable
Causes:
Apply O2,
CardiacMo

nitor, IV,
EKG

Symptoma
tic

Atropine
0.5mg
repeat
every 5

min. to
max of
3mg

If
Atropine
ineffective

Pacing

Dopamine
Infusion 210

mcg/kg/mi
n

Epinephrin
e Infusion

2-10
mcg/min

Treatabl
e Causes
H

ypoxia=
Apply O2
and assure
patent
airway

H
ypovolemi
a= Give
fluid bolus
of N/S

or LRconsi
der blood
H
ydrogen
Ion=

correct
acidosis,
advanced
airway,Cap
nography

H
ypothermia
= Keep
patient
warm,

while in
arrest
H
ypo/hyper
Kalemia=

check
potassium
& correct
T

oxins=
overdose
of what?
T

ension
Pneumotho
rax=
needle
decompres

sion
&chest
tube
T

amponade(
cardiac)=
pericardioc
entesisremove blo

od from
heart sac
T

hrombosis
(pulmonar
y) = PE
T

hrombosis
(cardiac) =
MI

Tachycar
dia With

Pulse
Algorith
m

Assess
clinical
conditionHR >150,
LOC,

color,Pain,
dizzy, B/P,
Symptomat
ic or non

Identify
Treatable
Causes:
Apply O2,
CardiacMo

nitor, IV,
EKG

Narrow
Stable

(SVT) Wid
e Stable
(VT)

Vagal man
euvers Ami
odarone 15
0 mgAden

osine 6 mg
over 10 mi
n.Adenosin
e 12 mg Ca
n consider

Adenosinei
f wide
monomorp
hic

Narrow
Unstable
(SVT) Wid
e Unstable

Regular=
50-100 J S
ynch Sync

h 100 JCar
dioversionI
rregular=
120-200J
Synch