Skip to main content

Pulseless Arrest Algorithm for Managing VF and Pulseless VT

Pulseless Arrest Algorithm for Managing VF and Pulseless VT

Version control: This document is current with respect to 2015 American Heart Association Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 2020. If you are reading this page after October 2020, please contact ACLS Training Center at support@acls.net for an updated document.

PDF Version

Algorithm download

Order the full set of
printed crash cart cards

Using the Pulseless Arrest Algorithm for Managing VF and Pulseless VT

The ACLS Pulseless Arrest Algorithm is the most important algorithm to know when resuscitating adults. The algorithm steps through the assessment and management of a patient with no pulse who does not respond to the interventions of the primary survey, including an initial shock from an automated external defibrillator (AED). Pulseless VT is included in the algorithm with VF. For treatment purposes, pulseless VT is treated the same as ventricular fibrillation

The Pulseless Arrest Algorithm picks up after the primary survey has already been conducted:

  • The emergency response system has been activated
  • CPR is being performed
  • An AED has been attached
  • The first shock has been given

Steps

Maintain CPR. Interrupt chest compressions only for ventilation, rhythm checks, and actual shock delivery. CPR should never be interrupted for more than 10 seconds. Remind team members that they can prepare the drugs used ahead of time and minimize patient's time without CPR.
  1. Begin 5 cycles of CPR (approximately 2 minutes) immediately after the first shock. Each cycle contains 30 chest compressions followed by 2 breaths.
  2. Attach the patient to the monitor/defibrillator and analyze the patient’s rhythm.
  3. Check the patient's rhythm in less than 10 seconds.
Rhythm
Condition
Action
If non-shockable rhythm is present
AND QRS complexes appear regular and narrow
Check for a pulse
If non-shockable rhythm is present
WITH no pulse
Follow treatment for PEA or asystole
If a shockable rhythm is present
WITHOUT a pulse
Continue CPR while defibrillator is charging
  1. Continue CPR until the defibrillator has been charged.
    • Turn oxygen away from the patient's chest OR turn it off.
    • Make sure the source of oxygen is removed from the patient when you clear to shock.
    • Check to see that no caregivers are touching the patient.
    • Shock. If using biphasic, use manufacturer recommended dosage.
      Press the shock button.
  2. Immediately resume CPR for 5 cycles.
  3. If IV/IO is available, administer Epinephrine 1mg IV/IO during the CPR cycle (see drug administration in PDF file on right).
  4. Check rhythm in less than 10 seconds.
  5. If a shockable rhythm is present, give 1 shock.
    • Continue CPR while the defibrillator is charging.
    • Clear the patient for shock .
    • Deliver the shock.
    • Resume CPR immediately after shock, 5 cycles.
Following the sequence in the algorithm is the best scientific approach to restore spontaneous circulation.

Comments

Popular posts from this blog

State of emergency medical services in Nigeria

EMERGENCY MEDICAL SERVICES (LASEMS AND LASAMBUS) EMERGENCY MEDICAL SERVICES (LASEMS AND LASAMBUS) Increasing urbanization and industrialization of Lagos State has led to an appreciable increase in the number of road traffic, industrial and marine accidents and medical emergencies, hence the strengthening of the inherited base hospital care i.e. Lagos State Emergency Medical Service (LASEMS) and establishment of the pre-hospital care service i.e. Lagos State Ambulance Service (LASAMBUS) in March 2001. Both services run on a 24/7 basis and have led to significant improvement in the response time and quality of care with attendant improvement in morbidity and mortality rates occasioned by medical emergencies. These services cover: • Awareness campaign on the preventive aspect of medical emergencies including home/road traffic/industrial accidents; and how to access services. • Training of personnel in pre-hospital and hospital-based management of trauma and medical emergencies, and effec...

Types of paramedics

Types of Paramedics Paramedics provide emergency medical response to more than 6 million people in an area of more than 227,000 square kilometres. In 2015-16, paramedics in Victoria responded to about 589,847 emergency road incidents – that’s one every 55 seconds. Paramedic expertise is not just applied at the scene of a patient. Paramedics are involved in the coordination of ambulance resources and dispatch as duty managers, clinicians and communications support personnel. Paramedics are also involved in our Secondary Triage Service which deals with 000 calls classified as low medical priority, where the patient’s condition indicates that an ambulance may not be necessary and an alternative service can be provided. This helps free up ambulances for life-threatening cases. The clinical, pharmacological and medical skills of our paramedics are of a very high standard. External surveys show that 97 per cent of patients are satisfied or very satisfied with overall with our ser...

Algorithms for Advanced Cardiac Life Support 2017

Algorithms for Advanced Cardiac Life Support 2017 https://www.acls.net/aclsalg.htm Oct 6, 2017 Version control:  This document is current with respect to 2015 American Heart Association Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 2020. If you are reading this page after October 2020, please contact ACLS Training Center at support@acls.net for an updated document. One of the crucial components of effective ACLS training is a familiarity with the major algorithms for different patient and/or provider scenarios. As a free resource for our visitors, this page contains links to sample algorithms for the main AHA Advanced Cardiac Life Support cases.  See our website terms . Compatible part number: 90-1013, 90-1010.     New!  We now sell laminated 8.5"x11"  crash cart algorithm cards  ( $60  $40 set of 8) and  24"x36" wall posters  ($80 set of 9). Cardiac Arrest Algorithm This c...