Download ventricular fibrillation - pulseless ventricular tachycardia (a01)

ADULT TREATMENT GUIDELINES
CARDIAC
VENTRICULAR FIBRILLATION - PULSELESS VENTRICULAR TACHYCARDIA (A01)
V-FIB: Bizarre, rapid, irregular, ineffective rhythm with electrical waveforms varying in size and
shape. There is no P wave. QRS complexes absent. V-fib may masquerade in one lead as
asystole.
V-TACH: Regular or slightly irregular rhythm. Heart rate 100 to 200. A-V dissociation. QRS
complex distorted, wide (> 0.12 seconds) and bizarre.
CPR
ORAL or NASAL PHARYNGEAL AIRWAY
VENTILATE with BVM and 100% OXYGEN.
DEFIBRILLATE - 200 J (Biphasic) (AED only for FR and EMT)
Reanalyze rhythm every 2 minutes.
VASCULAR ACCESS - IV/IO, rate as indicated.
EPINEPHRINE - 1 mg (10mL) 1:10,000 IV/IO push. Repeat every 3-5
minutes.
AMIODARONE - 300 mg IV/IO over 1–2 minutes, followed by 20mL NS.
Repeat once in 5 minutes at 150 mg IV/IO followed by 20mL NS.
LIDOCAINE - Consider if V-fib/V-Tach refractory to amiodarone. 1.5
mg/kg IV/IO push. Repeat at 0.75 mg/kg every 5-10 minutes, up to a
maximum of 3 mg/kg total.
MAGNESIUM SULFATE - For Torsade de Pointes 2gm IV/IO.
INTUBATE - BLS airway OK if airway is patent. Consider King Airway if
placement of an endotracheal tube will interrupt compressions for more
than 10 seconds.
TEST FOR GLUCOSE.
DEXTROSE - If blood glucose < 75 mg/dL, 25 – 50 gms IV/IO.
NALOXONE - 0.4 – 2 mg IV/IO/IN (if narcotic use is suspected).
SODIUM BICARBONATE - 1 mEq/kg IV/IO for known or suspected
hyperkalemia.
**CESSATION of RESUSCITATION - If patient remains in cardiac arrest
after two rounds of medications, if resuscitative measures have been
employed for a minimum of 10 minutes without an improvement in the
patient's condition, and if no reversible causes are identified.
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Refer to Treatment Guideline A10, Return of Spontaneous Circulation
**Refer to Policy #570.20, Determination of Death in the Prehospital Setting
Provider Key
F = First Responder
E = EMT
P = Paramedic
B = Base Hospital Order Required
D = Base Hospital Physician Order Required
EFFECTIVE: 11-01-2015
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