Call a code/notify HCP STAT. Pt requires immediate intervention!

• CPR: Push hard and fast, minimize interruptions, and avoid hyperventilation.
• Give oxygen, attach monitor/defibrillator, and assess rhythm.

Asystole/PEA

• CPR: 2 min. Obtain IV/IO access.
• Epinephrine: 1 mg IV/IO every 3–5 min.
• Consider advanced airway, capnography.
• Continue CPR, with rhythm check every 2 min and epi every 3–5 min.
• Search for and manage reversible causes.

V-Fib or Pulseless VT

• Shock: Biphasic, 120–200 J; monophasic, 360 J.
• CPR: 2 min—obtain IV/IO access—reassess rhythm.
• Shock: Biphasic: 120–200 J; monophasic: 360 J.
• CPR: 2 min—Epinephrine: 1 mg IV/IO every 3–5 min. Consider advanced airway, capnography and reassess rhythm.
• Shock: Biphasic: 120–200 J; monophasic: 360 J.
• CPR: 2 min—Antiarrhythmics:
• Amiodarone: 300 mg IV/IO. Repeat dose is 150 mg or
• Lidocaine: 1.0–1.5 mg/kg IV/IO, repeated 0.5–0.75 mg/kg every 5–10 min, maximum 3 doses or 3 mg/kg.
• Treat reversible causes and reassess rhythm.
• For torsade de pointes, give magnesium: 1–2 g (diluted in 10 mL) IV/IO.