Adult Cardiac Arrest - ACLS Circular Algorithm - AHA 2020 CPR Quality: • Push hard (at least 2 inches [5 cm]) and fast (100-120/min) and allow complete chest recoil. • Minimize interruptions in compressions. • Avoid excessive ventilation. • Change compressor every 2 minutes. or sooner if fatigued. • If no advanced airway. 30:2 compression-ventilation ratio. • Quantitative waveform capnography - If PETCO2 is low or decreasing, reassess CPR quality. Shock Energy for Defibrillation: • Biphasic: Manufacturer recommendation (eg. initial dose of 120-200 J); if unknown, use maximum available. Second and subsequent doses should be equivalent. and higher doses may be considered. • Monophasic: 360 J Drug Therapy: • Epinephrine IV/IO dose: 1 mg every 3-5 minutes • Amiodarone IV/IO dose: First dose: 300 mg bolus, Second dose: 150 mg OR • Lidocaine IVIIO dose: First dose: 1-1.5 mg/kg, Second dose: 0.5-0.75 mg/kg. Advanced Airway: • Endotracheal intubation or supraglottic advanced airway • Waveform capnography or capnometry to confirm and monitor ET tube placement • Once advanced airway in place, give 1 breath every 6 seconds (10 breaths/min) with continuous chest compressions Return of Spontaneous Circulation (ROSC): • Pulse and pressure • Abrupt sustained increase in PETCO2 (typically 240 mm Hg) • Spontaneous arterial pressure waves with intra-arterial Reversible Causes: • Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/hyper-kalemia, Hypothermia • Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis, (pulmonary), Thrombosis (coronary) #circular #ACLS #lifesupport #cardiacarrest #Algorithm #AHA2020 #management #adult
