ACLS review: Pulseless VF/VT Part 7
Drug Therapy:
Magnesium
Sodium Bicarbonate
Magnesium
1-2g diluted in 10cc of NS IV/IO push
Circulate drug with CPR for up to 2 minutes
Defibrillate at 200J or higher and analyze rhythm
Indicated for hypomagnesemia
Indicated for Torsades de pointes
Sodium Bicarbonate
1mEq/kg IV/IO push
Circulate drug with CPR for 30-60 sec.
Defibrillate at 200J or higher and analyze rhythm
Not given routinely. (Treate respiratory acidosis with adequate ventilations)
Indications: long arrest interval, ASA OD, Tricyclic OD, Know metabolic acidosis
Follow Up
Note: If the patient has ROSC, post–cardiac arrest care should be started. Of particular importance are treatment of hypoxemia and hypotension, early diagnosis and treatment of ST-elevation myocardial infarction (STEMI) (Class I, LOE B) and therapeutic hypothermia in comatose patients (Class I, LOE B).
Start infusion of antiarrhythmics if rhythm was responsive to the antiarrhythmic
–Amiodarone 900mg in 500cc D5W
1mg/min for 6hr, then 0.5mg/min for 18hr
–Lidocaine 2g in 500cc NS 1-4mg/min
Magnesium
Sodium Bicarbonate
Magnesium
1-2g diluted in 10cc of NS IV/IO push
Circulate drug with CPR for up to 2 minutes
Defibrillate at 200J or higher and analyze rhythm
Indicated for hypomagnesemia
Indicated for Torsades de pointes
Sodium Bicarbonate
1mEq/kg IV/IO push
Circulate drug with CPR for 30-60 sec.
Defibrillate at 200J or higher and analyze rhythm
Not given routinely. (Treate respiratory acidosis with adequate ventilations)
Indications: long arrest interval, ASA OD, Tricyclic OD, Know metabolic acidosis
Follow Up
Note: If the patient has ROSC, post–cardiac arrest care should be started. Of particular importance are treatment of hypoxemia and hypotension, early diagnosis and treatment of ST-elevation myocardial infarction (STEMI) (Class I, LOE B) and therapeutic hypothermia in comatose patients (Class I, LOE B).
References
1. Aehlert, Barbara. ACLS Quick Review Study Guide, 2nd edition. Mosby, Inc. St. Louis, Mo. 1994.
2. AHA (2010) Highlights of the 2010 American Heart Association Guidelines for CPR and ECC, p. 1. www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf ·
3. AHA (2010) Cardiopulmonary Resuscitation (CPR) Statistics. Retrieved December 17, 2010 from: http://www.americanheart.org/presenter.jhtml?identifier=4483.
Continue to monitor ABCs
Start infusion of antiarrhythmics if rhythm was responsive to the antiarrhythmic
–Amiodarone 900mg in 500cc D5W
1mg/min for 6hr, then 0.5mg/min for 18hr
–Lidocaine 2g in 500cc NS 1-4mg/min
Reviewed
2/28/16
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