Chest compression fraction acls12/11/2023 Lidocaine, Epinephrine, Atropine, Naloxone, and Vasopressin are Absorbed via ETT Administration.Typical ETT Drug Dose is 2.5x the Intravenous Dose.Generally Considered to be Inferior to Intravenous Drug Administration.There is evidence, however, that the use of vasopressor agents is associated with an increased rate of return of spontaneous circulationĮndotracheal Drug Administration (Via ETT) During Cardiac Arrest.To date no placebo-controlled trials have shown that administration of any vasopressor agent at any stage during management of VF, pulseless VT, PEA, or asystole increases the rate of neurologically intact survival to hospital discharge.Use of Vasopressors During Cardiac Arrest May Be Considered for Select Patients with Refractory Cardiac Arrest.Not to be used in isolation to determine if resuscitation should be discontinuedĮxtra-Corporeal Membrane Oxygenation (ECMO)/Percutaneous Cardiopulmonary Support (CPS) (see Percutaneous Cardiopulmonary Support, ]).Not to be used in non-intubated patients.Low End-Tidal pCO2 In Intubated Patients After 20 min of CPR: strongly associated with failure of resuscitation.Known/Suspected Opiate Intoxication (see Opiates, ]) Chest Compression Fraction: >60% (to avoid long interruptions in chest compressions and maximize coronary perfusion and blood flow during CPR).Depth of Chest Compressions: at least 2-2.4 in (5-6 cm).Rate of Chest Compressions: 100-120 compressions/min.Type III agent with modest beta-blocking propertiesĬardiopulmonary Resuscitation (CPR) Quality.Amiodarone (see Amiodarone, ]): useful for cases with rapid HR.Calcium Channel Blockers (see Calcium Channel Blockers, ]): useful.Multifocal Atrial Tachycardia (MAT) (see Multifocal Atrial Tachycardia, ]) Avoid AV nodal blocking agents with irregular wide-complex tachycardia of unknown etiology (ie: possible WPW), as these can cause paradoxical increase in HR or degeneration to VF in WPW.If Unknown or AF with WPW: Amiodarone (see Amiodarone, ]) 150 mg over 10 min (max: 2.2 g/24 hrs) -> Drip 1 mg/min x 6 hrs, then 0.5 mg/min x 18 hrs.If Torsades: Magnesium Sulfate (MgSO4) (see Magnesium Sulfate, ]): 1-2 IV over 1-2 min.Irregular (AF with Aberrrancy, AF with WPW, Torsade) Amiodarone (see Amiodarone, ]): 150 mg Over 10 min (max: 2.2 g/24 hrs) -> Drip 1 mg/min x 6 hrs, then 0.5 mg/min x 18 hrs.Only If Regular + Monomorphic: Adenosine (see Adenosine, ]) 6 mg -> 12 mg via peripheral IV.Wide-Complex Regular (VT, SVT with Aberrancy) Synchronized Cardioversion: Biphasic 120-200 J.Irregular (AF, MAT, Occasionally A-Flutter) Synchronized Cardioversion: Biphasic 50-100 J.Consider Adenosine (see Adenosine, ]): 6 mg -> 12 mg via peripheral IV.Calcium Channel Blockers (see Calcium Channel Blockers, ]).Metoprolol (see Metoprolol, ]): 5 mg IV.Beta Blockers (see β-Adrenergic Receptor Antagonists, ]).Use initial dose 50% less if given via central venous catheter, heart transplant, tegretol, dipyridamole.Adenosine (see Adenosine, ]): 6 mg -> 12 mg via peripheral IV.
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