2. Algorhythms are your best friend
Does he have
a pulse ?
No
Are you sure?
Transport to
hospital. Treat
as indicated
Yes
Transport to
hospital. Treat
as indicated
Is the patient
talking ?
No
Give oxygen
Transport to
hospital. Treat
as indicated
Yes
Take him to the
hospital. Treat
as indicated.
3. Main Algorhythms
CPR Algorhythm
Pulseless Arrest
Tachycardia with pulse
Bradycardia
ROSC
4. CPR Algorhythm (BLS
Code)
1. “Hey, hey, are
you okay?”
2. You are 911
3. Jaw thrust or
head tilt chin lift
4. Use an Ambu
bag and at least
one basic
airway adjunct
5. ONLY 10
seconds
6. Hard and fast
30:2
7. Turn on your
AED / Monitor
8. Rhythm check
9. Shock
10. Start CPR again
7. Pulseless Arrest
Call for assistance if
not already there
Use Ambu bag
Attach cardiac monitor
Check rhythm
Confirm V-fib or V-
tach
8. Pulseless Arrest
Shock at 200 J
Resume CPR
If you did not secure
an airway yet, do it
now.
Attach Auto Pulse
Establish IV or IO
access
Get ready with the
EPI
9. Pulseless Arrest
Check rhythm
Shock at 200 J
Restart CPR
Give either one:
EPINEPHRINE 1mg
VASOPRESSSIN 40
units
11. Pulseless Arrest
Rhythm Check
Shock
Give an antiarrhythmic:
LIDOCAINE 1 – 1.5 mg/kg
AMIODARONE 300 mg
Mag Sulfate if Torsades
12.
13. Pulseless Arrest
Package patient
Initiate transport
Reconfirm airway
Continue to give EPINEPHRINE q 3 -5 minutes
Repeat antiarrhythmics:
LIDOCAINE (0.5- 0.75 mg / kg ) half first dose
AMIODARONE (150 mg) half first dose
If you get a pulse back with one of these drugs, set up
a drip.
22. Tachycardia
OXYGEN
ECG
GOOD SET OF VITALS
ANY CAUSES?
Hyperventilation
Overdose
TREAT THE
PATIENT
NOT THE
MONITOR
23. TACHYCARDIA
STABLE OR
UNSTABLE
GO BACK TO
GENERAL
IMPRESSION
HOW LONG WILL
PATIENT TOLERATE
THE RHYTHM ?
HOW LONG HAS
THE PATIENT BEEN
IN THIS RHYTHM ?
24. TACHYCARDIA: Unstable
Establish IV
Sedate patient if
possible
Cardioversion:
Press Sync button
Press Shock (hold
down until it
discharges)
36. BRADYCARDIA
Less than 60 bpm
Is patient symptomatic ?
Some causes of bradycardia
Healthy, athletic person
Patient on beta blockers
Patient on digoxin
Overdose of narcotics
43. HOW TO WORK MEGACODES IN
CLASS
Use all help available
If you are working with a partner and you have a
helper
Person 1 - Airway
Person 2- Monitor then IV / drugs
Person 3 (1st responder or bystander)- Chest
compressions
Be serious
Use the ‘event’ button on LP 12
44. Amiodarone 3 Ways:
For VF/Pulseless V-Tach
V-Tach or wide complex regular
Maintenance Drip