Pulseless Arrest Algorithm
Pulseless Arrest Algorithm
The Pulseless Arrest Algorithm takes its place as the most important algorithm in the ACLS Protocol. There are 4 rhythms that produce pulseless 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 this algorithm. Therefore, it is very important to master the pulseless arrest algorithm. 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 revised algorithm.
I notice in the video that it emphasizes minimal interruption of compressions yet still states 30/2 as the correct compression/ventilation ratio. Isn’t this a contradiction?
Awesome site. I’m amazed at the logic and thoroughness of it. Thanks for taking our money and giving us a much greater value in return when the opposite is nearly always the case at other sites.
Dwayne
Hi Dwayne,
Thanks for the encouragement and feedback. With regard to the minimal interruption of chest compressions and the 30/2 compression to ventilation ratio. I would not say this is a contradiction if you have multiple rescuers. Until multiple rescuers are present in the room it would be appropriate to just do compressions according to the guidelines, but once a second rescuer is present, the 30/2 ventilation ratio could be maintained w/o much of an interruption in chest compressions.—regards, Jeff
I watched a pt go flat line when he went pale and passed out after a cataract surgery. I called for help, lowered the hob, and while I was lowering the height of the bed, I gave a precordial thump. There was a spike from the thump as witnessed by another nurse and immediate return of pulse. By the time the bed was at a height to do CPR, pt’s color was already returning, and there was a pulse. This precordial thump worked well.
wow thats great! thanks for sharing
SO VASOPRESSIN IS TO BE GIVEN ONLY ONE TIME DURING THE WHOLE CODE?
correct
I really like this site even though all tachycardia algorithms are not done. i do have a question that i could not find. is pre cordial thump still in if wittnessed arrest?
Hi Mike,
To use precordial thump the arrest must be witness and monitored.
Here is what AHA now says. I could not find any info in the AHA manual about precordial thump, in a review of the following I found this. This information came form the 2010 AHA Highlights found at this link:
http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadabl
e/ucm_317350.pdf
“2010 (New): The precordial thump should not be used for
unwitnessed out-of-hospital cardiac arrest. The precordial
thump may be considered for patients with witnessed,
monitored, unstable VT (including pulseless VT) if a defibrillator
is not immediately ready for use, but it should not delay CPR
and shock delivery.”
(Highlights of the 2010 AHA Guidelines for CPR and ECC; pg. 11)
Kind Regards,
Jeff
acls-algorithms.com
This is a great site, very instructional and easy to follow.
very conveninet to have available