Adults

Adult Cardiac Arrest – VF/VT

Diagnosis

Shockable pulseless cardiac arrest

Diagnosis

Shockable pulseless cardiac arrest

  1. Call for help and a code cart

    • Ask: "Who will be the crisis manager?"
    • Say: "Shock patient as soon as the defibrillator arrives"
    • Crisis manager assigns roles (see ROLE assignments box)

  2. Put backboard under patient

    • Turn supine as soon as possible, but do not delay the start of compressions

  3. Turn FiO2 to 100%; turn off volatile anesthetics

  4. Start CPR - defibrillation - assessment cycle

    • Perform high-quality CPR
      • "Hard and fast" about 100 – 120 compressions/min to depth ≥ 2 inches
      • Ensure full chest recoil with minimal interruptions
      • 10 breaths/minute; do not over-ventilate
        • Bag-mask ventilation until able to place endotracheal tube
    • Defibrillate
      • Shock at highest setting
      • Resume CPR immediately after shock
    • Give EPINEPHrine
      • Repeat EPINEPHrine every 3 – 5 minutes
    • Give antiarrhythmics for refractory VF/VT after 2 shocks
    • Assess every 2 minutes
      • Change CPR compression provider
      • Check ETCO2
        • If: <10 mm Hg, evaluate CPR technique
        • If: Sudden increase to >40 mm Hg, may indicate return of spontaneous circulation
      • Treat reversible causes, consider reading aloud differential diagnoses
      • Check rhythm; if rhythm organized, check pulse
    • 1 mg IV, repeat every 3 – 5 minutes

  5. Consider ECMO

Patient weight

Between 30 kg and 250 kg

Reset the checklist?

Checked steps, the timer and this crisis log are cleared. The patient’s weight is kept.

Finish the crisis?

The timer pauses, and you can review the case and the event log.