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ALS algorithm- reproduced with kind permission of Resuscitation Council (UK)
Unresponsive and not
breathing normally-Call resuscitation
team-CPR 30:2
Attach defibrillator/monitor
Minimise interruptions
Assess rhythm -Shockable
(VF/Pulseless VT)
1 Shock
Minimise interruptions
Immediately resume
CPR for 2 min
Minimise interruptions
Return of spontaneous
circulation
Immediate post cardiac
arrest treatment
ï‚· Use ABCDE approach
ï‚· Aim for SpO2 of 94-98%
ï‚· Aim for normal PaCO2
ï‚· 12-lead ECG
ï‚· Treat precipitating cause
ï‚· Targeted temperature
management
Non-shockable
(PEA/Asystole)
Immediately resume
CPR for 2 min
Minimise interruptions
During CPR
ï‚· Ensure high quality chest compressions
ï‚· Minimise interruptions to compressions
ï‚· Give oxygen
ï‚· Use waveform capnography
ï‚· Continuous compressions when
advanced airway in place
ï‚· Vascular access (intravenous or
intraosseous)
ï‚· Give adrenaline every 3-5 min
ï‚· Give amiodarone after 3 shocks
Treat Reversible Causes
ï‚· Hypoxia
ï‚· Hypovolaemia
ï‚· Hypo-/hyperkalaemia/metabolic
ï‚· Hypothermia
ï‚· Thrombosis - coronary or
pulmonary
ï‚· Tension pneumothorax
 Tamponade – cardiac
ï‚· Toxins
Assess rhythm
Consider
ï‚· Ultrasound imaging
ï‚· Mechanical chest
compressions to facilitate
transfer/treatment
ï‚· Coronary angiography and
percutaneous coronary
intervention
ï‚· Extracorporeal CPR
From https://www.resus.org.uk/resuscitation-guidelines/adult-advanced-life-support/
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