Adult Cardiac Arrest Algorithm Changes - Learn & Master ACLS/PALS


  1. Wahaj Fatmi says

    Hi, with regards to shock able rhythm and timing of first dose of epinephrine, is it necessary to give first dose of epinephrine after 2 cycles of shock or we should give epinephrine as soon as IV access is obtained.
    Secondly should the drugs i.e. epinephrine and amiodarone be given during active compression so as to improve the drug delivery or during the pulse check interval.

    • ACLS says

      American heart association puts Epinephrine after the second shock during CPR. This ensures that there will be no delay in chest compressions and ventilations. It is up to the physician’s discretion whether to follow the algorithm strictly or to give the epi after the first shock during CPR. Some do this.

      Medication’s should always be given just after the shock during CPR. This helps ensure adequate drug delivery.

      Kind regards,

  2. kadry says

    if we start the algorithm with non shockable rhythm , and started to give epinephrine every 4 minutes , and rhythm changed to shockable rhythm , should we stopped epinephrine and start again after 2nd shock , or to continue epinephrine every 4 minutes as epinephrine once started never stopped ??
    Thank you in advance

  3. Rob Lee says

    Thank you for your guys’ dedication to this material!

    – Former Army medic soon to be RN BSN

  4. Laura Cox says

    Hi! Did the joules for monophasic defibrillation change? Wasn’t it 200, 300, 360? And is it now just 360J from the start? Thanks.

    • ACLS says

      For some time the monophasic dosing calls for 1st dose to be 360 J and all subsequent doses to be 360 J. I think this was a 2010 change.

      Kind regards,

Leave a Reply

Your email address will not be published. Required fields are marked *

I accept the Privacy Policy