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Medication Administration and Cardiac Arrest
22/10/10
SP Notes
ARC - “While the listed drugs have theoretical benefits in selected situations, no medication
has been shown o improve long term survival in humans after cardiac arrest. Priorities are
defibrillation, oxygenation and ventilation together with external cardiac compression.”
American and European Resuscitation Guidelines (Resuscitation, 2010)
Adrenaline
- 1mg IV/IO Q 3min
- part of ALCS
- physiological and pharmacological with some animal data
Amiodarone
- 300mg IV
- part of ALCS
- given for refractory VF after 3rd shock
Atropine
- was given during PEA or asystole
- now no longer recommended
O2
- recognition that hyperoxaemia can be harmful after ROSC
- titrate to SpO2 94-98%
Drugs vs No Drugs
- recent Norwegian RCT (Olasveengen, JAMA 2010) – IV drug administration vs No drug
administration -> increases short term survival but no difference in hospital discharge, quality
of CPR or long term survival (1 year)
Jeremy Fernando (2011)
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