ACLS Cardiac Arrest VTach and VFib Algorithm

1. Perform the initial assessment
   • Perform high-quality CPR
   • Establish an airway and provide oxygen to keep oxygen saturation > 94%
   • Monitor the victim’s heart rhythm and blood pressure
2. If the patient is in VTach or VFib, this IS a shockable rhythm
3. Apply defibrillator pads (or paddles) and shock the patient with 120-200 Joules on a biphasic defibrillator or 360 Joules using a monophasic.
4. Continue High Quality CPR for 2 minutes (while others are attempting to establish IV or IO access).
5. After 2 minutes of CPR, check rhythm
6. If the monitor and assessment show asystole or PEA, move to Asystole/ PEA algorithm
7. Give epinephrine 1 mg every 3-5 minutes
8. Continue High Quality CPR for 2 minutes (while others are attempting to establish IV or IO access).
9. After 2 minutes of CPR, check rhythm
10. If needed, administer shock
11. Amiodarone IV 300 mg (preferable to lidocaine); May repeat 150 mg OR may use lidocaine 1-1.5 mg/kg
12. After 2 minutes of CPR, check rhythm
13. If needed, administer shock
14. If the patient attains Return of Spontaneous Circulation (ROSC), provide Post Cardiac Arrest Care