Unresponsive, no breathing or no normal breathing (only gasping) or no pulse palpated in 10 seconds
Compressions, Airway, Breathing
30 compressions/ 2 breaths. At least 100 per minute
At least two inches deep (5cm)
If rescuer is untrained or trained and not proficient: Compressions only
Pt. unresponsive, Call 911, Check for Pulse for 10 seconds, no pulse: start 30 compressions + two breaths cycle, AED/defibulator arrives: check for Shockable rhythm, give one shock, resume CPR immediately for 2 minutes and continue shocking and CPR
High quality CPR
Rate at least 100/min., compression depth 2 inches, allow complete chest recoil after each compression, minimize chest compressions, avoid excessive ventilation
Unresponsive with definite pulse
Call 911. No compressions. Give 1 breath every 5-6 seconds. Recheck pulse every 2 minutes.
Should be planned around uninterrupted periods of CPR
Interventions such as airway insertion, rhythm checks, and drug administration
one shock strategy
may improve outcomes by reducing interruptions in chest compressions
end tidal carbon dioxide device and esophageal detector devices
are indicated for the primary confirmation of correct tracheal tube placement
After advanced airway is inserted
Continue rescue breaths for CPR at about one breath every 6 seconds without pausing CPR compressions
IV large bore catheter
administer fluids if you suspect hypovolemia, then epinephrine, vasopressin or dopamine, as ordered.
Immediately following defibrillation
Perform CPR for 2 minutes then administer drugs
H and T mnemonic
used to determine a differential diagnosis: H&T's. hypoxia, hypovolemia, hydrogen ion (acidosis), hypo or hyperkalemia, hypo or hypercalemia. tablets, tamponade, tension pneumothorax, thormbosis (pulmonary and coronary) and trauma.
VF and pulseless ventricular tachycardia
one shock, then CPR, then shock, then epinephrine or vasopressin), then shock and start antiarrhythmic (amiodarone, lidocaine, magnesium)
Asystole and pulseless electrical activity PEA
vasopressin before epinephrine 40 unit, IV, one time only
Asystole or a slow PEA under 60 bpm (bradycardia)
transcutaneous pacing if patient has second degree type 2 or 3rd degree heart block.
tachycardia with pulses
If stable, EKG to determine the QRS complex is narrow or wide and if the rhythm is regular or irregular. if unstable: immediate synchronized cardioversion followed by drug therapy
Team based BLS/CPR for adults
Chest compressions, airway, breathing, defibrillation all done simultaneously in a in-hospital situation.