ACLS / PALS / BLS

Created by superdogjdog 

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PALS 1st shock for VF/VT

2 J / Kg (or AED)

PALS 2nd shock for VF/VT

4 J / Kg (or AED)

PALS Epinephrine dosage

0.01 mg / kg Repeat every 5 minutes

PALS CPR Cycles

30:2 unless 2-person AND neonate, then 15:2

PALS VF/VT Pathway

Shockable? (2 J/kg)
5 cycles CPR
*Shockable? (4 J/kg)
Epinephrine 0.01 mg/kg q 3-5 min
5 cycles CPR
Repeat from * & consider antiarrhythmics:
(Amiodarone 5 mg/kg or Lidocaine 1 mg/kg)
(Mag 25-50 mg/kg max 2g for torsades)

PALS Antiarrhythmics

Amiodarone 5 mg/kg
or
Lidocaine 1 mg/kg

Mag 25-50 mg/kg max 2g for torsades

PALS SVT vs S Tachy

No P waves
>220 Infants
>180 Children

PALS treatment for SVT

(>220 Infants, >180 Children & Symptomatic)
Vagal maneuvers
Adenosine RAPID infusion: 0.1 mg/kg (max 1st dose 6 mg)
Double for 2nd dose (only attempt x2)
Synchronized cardioversion (0.5 J/kg-1 J/kg)
Increase to 2 J/kg if unsuccessful

PALS treatment for symptomatic Tachycardia

Synchronized cardioversion (0.5 J/kg-1 J/kg)
Increase to 2 J/kg if unsuccessful
Start Amiodarone infusion 5mg/kg over 20-60 minutes

PALS treatment for bradycardia

Epinephrine 0.01 mg/kg, repeat every 3-5 minutes
Atropine 0.02 mg/kg (must be between 0.1mg-1mg)
Consider pacing

PALS Septic shock treatment

-20ml/kg fluid boluses x 3-4+
-Correct hypoglycemia & hypocalcemia
-Norepinephrine +/- vasopressin & corticosteroids (ACTH stim test) for vasodilated "warm sepsis"
-Hgb<10 give blood
-Epinephrine for vasoconstricted "cold shock"

PALS Calcium Dose & Indication

Only for known/suspected hypocalcemia
20 mg/kg Calcium Chloride SLOW IV push

ACLS VF/VT Pathway

-Biphasic shock 120-200 J (350 J monophasic)
-CPR x 5 cycles

-Biphasic shock 120-200 J (350 J monophasic)
-CPR (5 cycles before next rhythm check)
-Epinephrine 1mg IV q 3-5 min
-OR Vasopressin 40 Units IV to replace 1st or 2nd dose epi (esp. for poss hypovolemia)

-After 2 shocks & 2 cycles CPR consider Antiarrhythmics

Antiarrhythmics for ACLS

Amiodarone 300 mg IV x1 then 150mg (2nd dose) or
Magnesium 1-2 g IV for torsades

ACLS Asystole/PEA Pathway

(not shockable)
CPR (x5 cycles before next rhythm check)
-Epinephrine 1mg IV q 3-5 min
-OR Vasopressin 40 Units IV to replace 1st or 2nd dose epi (esp. for poss hypovolemia)
-Atropine 1mg IV for asystole / slow PEA q3-5 x 3 doses

H & T (Possible contributing factors) (5 ea)

Hypo-hyperkalemia
Hydrogen Ion (acidosis)
Hypoxia
Hypovolemia
Hypothermia
Tension Pneumothorax
Thrombosis
Tamponade
Toxins
Trauma

ACLS Tachycardia (with pulses) pathway

(Pt Unstable)
-Synchronized cardioversion

-Adenosine 6mg rapid push.
-If no conversion then 12mg. May repeat 12mg x1.

ACLS Bradycardia pathway

(Pt unstable)
-Transcutaneous pacing
(If from vagal response)
-Atropine 0.5mg IV. Max up to 3mg.

Consider:
-Epinephrine drip 2-10 mcg/min
-Dopamine drip 2-10 mcg/kg/min

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