ACLS review: Pulseless Electrical Activity- part 4

Peripheral IV Drug Delivery

·         Adults peak drug concentrations are lower and circulation times longer

·         Does not require interruption of CPR

·         Administer the drug by bolus injection and follow with a 20-mL bolus of IV fluid

·         Elevate the extremity for 10 to 20 seconds to facilitate drug delivery to the central circulation.

Endotracheal Drug Delivery

·         Results in lower blood concentrations than the same dose given intravascularly.

·         Give 2 to 2½ times the recommended IV dose.

·         Providers should dilute the recommended dose in 5 to 10 ml of water or normal saline and inject the drug directly into the endotracheal tube

Intraosseous Drug Delivery

·         Enables drug delivery similar to that achieved by peripheral venous access at comparable doses.

·         Is safe and effective for fluid resuscitation, drug delivery, and  blood sampling

·         Is attainable in all age groups.

Central IV Drug Delivery

·         Peak drug concentrations are higher and drug circulation times shorter

·         Central line placement can interrupt CPR.

·         A central line extending into the superior vena cava can be used to monitor SCVO2 and estimate CPP during CPR, both of which are predictive of ROSC


Reviewed 2/28/16