Copyright 2010 American Heart Association
ACLS Cardiac Arrest Algorithm
Neumar, R. W. et al. Circulation 2010;122:S729-S767
ACLS Cardiac Arrest Circular Algorithm
Neumar, R. W. et al. Circulation 2010;122:S729-S767
Bradycardia Algorithm
Neumar, R. W. et al. Circulation 2010;122:S729-S767
Tachycardia Algorithm
Neumar, R. W. et al. Circulation 2010;122:S729-S767
Post-cardiac arrest care algorithm
Peberdy, M. A. et al. Circulation 2010;122:S768-S786
Acute Coronary Syndromes Algorithm
O'Connor, R. E. et al. Circulation 2010;122:S787-S817
Goals for management of patients with suspected stroke
Jauch, E. C. et al. Circulation 2010;122:S818-S828
ACLS Code Drugs
Drug
Adenosine/
Adenocard
Amiodarone
Atropine
Indications
Narrow PSVT/SVT
Wide QRS Tachy of
uncertain cardiac origin
Vfib/pulseless VT,
VT with a pulse. May be
used for rate control of
WPW or atrial tachycardias.
Symptomatic sinus
bradycardia.
Dosage
6 mg followed by 12mg in 1-2
min.
300mg IVP for cardiac arrest.
Consider repeating with 150mg
in 3-5 min.
150mg over 10 min for stable
VT, may repeat 150mg every 10
min as needed. Cumulative dose
of 2.2 IV in 24 hrs.
Slow infusion 360mg IV over 6
hrs, maintenance 540mg over 18
hrs. (0.5mg/min)
Administration
Rapid IV push close to the
hub followed by a saline
bolus.
Draw up with filtered
needle. Administer drip with
filtered tubing.
Gtt infusion mixed
900mg/500 D5W.
1mg/min = 33.3cc/hr
.5mg/min = 16.6cc/hr
Half life is up to 40 days.
.5 mg IV every 3-5 min for
bradycardia, not to exceed 3 mg
Do not give less than 0.5mg
IV.
Tracheal 2-3mg diluted in 10cc
NS.
May be given IV, IO, or ET
Does not work with heart
transplant patients due to
denervation.
Calcium Chloride
Known or suspected
hyperkalemia (renal fx).
Hypocalcemia after multiple
blood tx. Antidote for
calcium channel blockers or
beta blocker overdose
8-16mg/kg IV for hyperkalemia
and calcium channel blocker
overdose.
Do not mix with sodium
bicarbonate.
Dopamine
Used for hypotension with
signs and symptoms of
shock or bradycardia
Mixed 400mg/250D5W
IV line must be a good one.
Will cause extravasation
with infiltration
Epinephrine
Cardiac arrest, VF, pulseless
VT, asystole, PEA
Symptomatic bradycardia,
severe hypotension,
anaphylaxis
2-10mcg/kg/min.
Cardiac arrest: 1mg of the
1:10,000 administered q 3-5 min
follow each dose with IV flush.
Do not mix with sodium
bicarbonate.
1mg/250cc: 1mcg/min = 15
cc/hr.
May be given IV, IO or ET
Bradycardia or hypotension use
a gtt.
Drug
Magnesium Sulfate
Morphine Sulfate
Indications
Dosage
Administration
Torsades de pointes or
suspected hypomagnesemia.
Life threatening arrhythmias
due to dig toxicity.
1-2 gm diluted in 10 cc D5W
IVP if in cardiac arrest.
May cause fall in BP with
rapid administration.
If not in cardiac arrest mix 1-2
gm in; 50 to 100 cc D5W to
infuse over 5 to 60 min.
Use with caution if renal
failure is present.
Used for treatment of
ischemic chest pain, acute
cardiogenic pulmonary
edema, anxiety
Dosage should be in 1 to 2 mg
increments up to 10 mg max
Given slow IV over 1-2 min
Precautions: respiratory
depression and hypotension
Decreases the myocardial
preload and causes
peripheral venous pooling.
Narcan/Naloxone
Used to reverse respiratory
depression that results from
narcotics
Dosage 0.4 mg to 2 mg IV or
IO and may be given ET
IV or IO meds should be
given over 1 min.
Precautions: If given rapidly
IV/IO can cause projectile
vomiting
Also used for coma of
unknown etiology
Patient may become
agitated or violent
Procainamide
Anti-arrhythmic for stable
wide QRS Tachycardia
20-50 mg/min
Sotalol
Hemodynamically Stable
Monomorphic Ventricular
Tachycardia
3rd Line Anti-Arrhythmic
Preexisting hyperkalemia,
metabolic acidosis,
prolonged resuscitation.
100 mg over 5 min or
1.5 mg/kg over 5 min
Sodium Bicarbonate
Vasopressin
May be used as an
alternative pressor to epi in
the treatment of Cardiac
Arrest instead of 1st or 2nd
dose of epi
End Points: Arrhythmia
suppressed, hypotension
ensues, QRS duration
increase >50%, max dose
17 mg/kg
Avoid if prolonged QT
1 meq/kg IV bolus.
Repeat half dose q 10 min
Not recommended for
routine use in cardiac arrest
patients.
IV, IO 40 U IV push X 1 dose
only.
ET 80U X 1 dose only
Do not give any epi for
10 min after vosopressin is
given.
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