# Pulseless Arrest Algorithm

## Pulseless Arrest (Cardiac Arrest) Algorithm

The Pulseless Arrest Algorithm which is now known as the Cardiac Arrest Algorithm takes its place as the most important algorithm in the ACLS Protocol. There are 4 rhythms that are seen with pulseless cardiac arrest. These four rhythms are pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA). Visit the links above for detailed information about each of the rhythms and their treatment in the ACLS protocol.

The majority of patients that experience sudden cardiac arrest will be treated with the Cardiac Arrest Algorithm. Therefore, mastery of this algorithm is very important. There are 2 branches to the Cardiac Arrest Algorithm, the left and right branch. The left branch is used for the treatment of pulseless ventricular tachycardia and ventricular fibrillation, and the right branch is used for the treatment of PEA and Asystole. Watch Part 1 and Part 2 of the Cardiac Arrest Video Review.

Also, In 2010 the AHA released new ACLS guidelines that simplified the pulseless arrest algorithm. Use this link to watch a short video that reviews the 2010 Simplified Pulseless Arrest Algorithm.

Hi Jeff. This will be my first time to do ACLS. My question is: Are there ACLS drugs that are not to be used during a cardiac arrest of a pregnant patient. Thank you.

During pregnancy, the medications used to treat cardiac arrest are the same. Kind regards, Jeff

Hi!

First of all i would like to say that this website is amazing. Thank you for the endless resources! I just have a quick question in regards to your answer to the above question. I thought that VT with a pulse would warrant using the other side of the Cardiac Arrest algorithm (shock, CPR, epi, amiodarone,etc.) instead of just treating with the tachycardia algorithm which I take to mean treating with vagal maneuvers, beta blockers, and adenosine depending on how high the heart rate is. Was just wondering if you could clarify your answer.

Thanks again,

Audra

If a person has VT with a pulse then the treatment would being using the tachycardia algorithm. If they are unstable but have a pulse, the tachycardia algorithm would call for synchronized cardioversion.

The tachycardia algorithm deals with both narrow and wide QRS tachycardia and both unstable and stable tachycardia.

The pulseless arrest algorithm deals with the treatment of pulseless arrest.

Hope this makes sense,

Kind regards,

Jeff

Is there a ventricular tachycardia with a pulse?

Yes, you can have VT with a pulse. This is treated with the tachycardia algorithm.

Kind regards,

Jeff

Hi Jeff,

Thank you so much for the endless effort you are making on this site to help people so that ACLS is easily understandable. I build up my confidence since I join your site!!!

I have one Q… If the only choice we have is Vasopressin during adult cardiac arrest algorism managing VT/VF , can we administer Vasopressin every 3-5 minutes as much as we needed? or is there any max dose we have to administer like Epinephrine.

Vasopressin should only be administered once because, the half-life of vasopressin is 10-35 minutes. This means that it will remain in the system for at least 20 minutes.

The reason why epinephrine is give every 3-5 minutes is that the half-life of is 2-3 minutes. This means that it will remain in the system for at least 4 minutes.

Vasopressin should only need to be given once during a code.

Kind regards,

Jeff