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Writer's pictureMark Nguyen, PharmD, BCEMP

Cardiac Arrest: Shockable - #PHARMFAX

Found someone pulseless and unresponsive? That’s your sign to start #CPR.

 

Found someone pulseless and unresponsive? That’s your sign to start #CPR. Theres two pathways in a cardiac arrest; shockable and non-shockable rhythms. Ventricular Fibrillation and Pulseless Ventricular Tachycardia are shockable rhythms and are on the left branch of the ACLS algorithm. CPR is the mainstay therapy of cardiac arrest; it maintains blood flow and perfusion to your vital organs, like your brain. When VF/pVT are confirmed on a monitor, earlier defibrillation is associated with increased likelihood of successful termination. Our patient-centered outcome interventions for VF/pVT are assessing for a shockable rhythm every 2 minutes with continuous CPR. Medications given in a cardiac arrest only improve rates of Return of Spontaneous Circulation (ROSC) with benefit on mortality or neurologic outcomes. We’ll give epinephrine 1 mg IV/IO every 3 to 5 minutes per the ACLS recommendations. After the third defibrillation, we’ll give antiarryhtmics. #Amiodarone 300 mg IV, then 150 mg the next round or #lidocaine 1 - 1.5 mg/kg, then 0.5 - 0.5 mg/kg. Patients with a shockable rhythm are more likely to be ACS-related and survive compared to non-shockable rhythyms. Administration of #epinephrine before CPR and defibrillation for VF/pVT is associated with reduced survivability. We always need to be thinking of reversal causes and our H/Ts. For more #PHARMFAX in the drug bank, I’d appreciate a follow, share with a friend, and I hope you learned something new.


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Not medical advice. Educational purposes only. No relationships to report. I hope you learned something new.

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