ACLS Algorithms Slide

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   Assess responsiveness (speak loudly, gently shake patient if no trauma - Annie, Annie, are you OK? ).  Call for help/crash cart if unresponsive.   ABCD‘s   ◦   irway   Open airway, look, listen, and feel for breathing. ◦   reathing   If not breathing, slowly give 2 rescue breaths. ◦  C irculation  Check pulse. If pulseless, begin chest compressions at 100/min, 15:2 ratio. Consider no defibrillator nearby ◦  D efibrillation  Attach monitor, determine rhythm. If VF or pulseless VT: shock up to 3 times. If not, basic CPR.  Then, move quickly to Secondary Survey.   After initial (primary) assessment done  Another set of ABCD‘s   ◦   irway  Establish and secure an airway device (ETT, LMA, COPA, Combitube, etc.). ◦   reathing  Ventilate with 100% O2. Confirm airway placement (exam, ETCO2, and SpO2). Remember, no metabolism/circulation = no blue blood to lungs = no ETCO2. ◦  C irculation  Evaluate rhythm, pulse. If pulseless continue CPR, obtain IV access, give rhythm-appropriate medications ◦  D ifferential Diagnosis  Identify and treat reversible causes.   Treatment ◦ Consider bicarb, pacing early ◦   icarb (NaHCO3) ◦  E pinephrine 1 mg IV q3-5 min ◦   tropine 1 mg IV q3-5 min. Max 0.04 mg/kg  Consider possible causes ◦  H ypoxia, H yperkalemia, H ypothermia, D rug overdose (e.g., tricyclics), M yocardial Infarction  Consider termination. If patient had >10min with adequate resucitative effort and no treatable causes present   Always Primary Survey - Secondary Survey: Confirm rhythm (check monitor, power, different lead)
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