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Writer's pictureMark Nguyen, PharmD, BCEMP

Cardiac Arrest: Shockable - #MEDSHED

Updated: Sep 15, 2023

CPR is the mainstay of therapy for both shockable and nonshockable rhythms. Ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) are shockable rhythms.

 



 

💉 Cardiac Arrest: Shockable 📋


CPR is the mainstay of therapy for both shockable and nonshockable rhythms. Ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) are shockable rhythms.


Defibrillation is the definitive treatment. High-quality CPR throughout and assessing for pulse/shockable rhythm every 2 minutes maximizes our chances for a successful resuscitation and maintains organ perfusion.


Medications are only associated with improved rates of ROSC. Epinephrine 1 mg IV/IO every 3 to 5 minutes is given. Antiarryhtmics include amiodarone 300 mg, then 150 mg IV/IO OR lidocaine 1 - 1.5 mg/kg, then 0.5 - 0.75 mg/kg.


Refractory cases are associated with worse outcomes. Consider dual sequential external defibrillation (DSED) and/or esmolol if standard ACLS measures have been exhausted.


 

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