The Algorithms for Bradyarrhythmia/Asystole (Left) or Pulseless Electrical Activity (Right) are Dominated First by Continued Life Support and a Search for Reversible Causes - Flowchart
The Algorithms for Bradyarrhythmia/Asystole (Left) or Pulseless Electrical Activity (Right) are Dominated First by Continued Life Support and a Search for Reversible Causes - Flowchart
«Flowchart»

Start

Start

Start

CPR, intubate, IV access

CPR, intubate, IV access

CPR, intubate, IV access

CPR, intubate, IV access

CPR, intubate, IV access

CPR, intubate, IV access

Bradyarrhythmia/Asystole

Bradyarrhythmia/Asystole

Bradyarrhythmia/Asystole Bradyarrhythmia/Asystole

Pulseless Electrical Activity

Pulseless Electrical Activity

Pulseless Electrical Activity Pulseless Electrical Activity

[Confirm asystole]

[Confirm asystole]

[Confirm asystole]

Identify and treat causes

Identify and treat causes

Identify and treat causes


Hypoxia
Hyper-/hypokalemia
Severe acidosis
Drug overdose
Hypothermia


Hypoxia
Hyper-/hypokalemia
Severe acidosis
Drug overdose
Hypothermia


Hypoxia
Hyper-/hypokalemia
Severe acidosis
Drug overdose
Hypothermia


Hypoxia
Hyper-/hypokalemia
Severe acidosis
Drug overdose
Hypothermia

End

End

End

Pacing—External or pacing wire

Pacing—External or pacing wire

Pacing

Epinephrine
1 mg IV (repeat)

Atropine
1 mg IV (only for bradycardia)

Sodium bicarbonate
1 meq/kg IV (no longer for routine use; may be used for persistent acidosis—see text)

Epinephrine
1 mg IV (repeat)


Atropine
1 mg IV (only for bradycardia)


Sodium bicarbonate
1 meq/kg IV (no longer for routine use; may be used for persistent acidosis—see text)


Epinephrine

[Assess blood flow]

[Assess blood flow]

[Assess blood flow]


Hypovolemia
Hypoxia
Tamponade
Pneumothorax
Hypothermia
Pulmonary embolus
Drug overdose
Hyperkalemia
Severe acidosis
Massive acute MI


Hypovolemia
Hypoxia
Tamponade
Pneumothorax
Hypothermia
Pulmonary embolus
Drug overdose
Hyperkalemia
Severe acidosis
Massive acute MI


Hypovolemia
Hypoxia
Tamponade
Pneumothorax
Hypothermia
Pulmonary embolus
Drug overdose
Hyperkalemia
Severe acidosis
Massive acute MI


Hypovolemia
Hypoxia
Tamponade
Pneumothorax
Hypothermia
Pulmonary embolus
Drug overdose
Hyperkalemia
Severe acidosis
Massive acute MI

Epinephrine
1 mg IV (repeat)

Atropine
1 mg IV (only for bradycardia)

Sodium bicarbonate
1 meq/kg IV (no longer for routine use; may be used for persistent acidosis—see text)

Epinephrine
1 mg IV (repeat)

Atropine
1 mg IV (only for bradycardia)

Sodium bicarbonate
1 meq/kg IV (no longer for routine use; may be used for persistent acidosis—see text)

Epinephrine
1 mg IV (repeat)


Atropine
1 mg IV (only for bradycardia)


Sodium bicarbonate
1 meq/kg IV (no longer for routine use; may be used for persistent acidosis—see text)