Module 07
Cardiac Arrest
Recognize arrest, identify the rhythm, and run the correct shockable or non-shockable algorithm.
Cardiac Arrest Recognition
- Recognize arrest by:
- — Unresponsiveness
- — No normal breathing
- — Agonal respirations (NOT normal breathing)
- — No pulse
- Begin CPR immediately upon recognition.
Shockable Rhythms: VF / Pulseless VT
1
Begin high-quality CPR
Minimize interruptions, maximize compression fraction.
2
Defibrillate as soon as available
Resume compressions immediately after the shock.
3
Epinephrine 1 mg IV/IO every 3–5 minutes
Continue throughout the arrest.
4
Amiodarone for shock-refractory VF/VT
300 mg bolus, then 150 mg if needed.
5
Search for and treat reversible causes
Run through the Hs and Ts continuously.
Non-Shockable Rhythms: Asystole / PEA
1
Begin high-quality CPR
Foundation of all arrest management.
2
Epinephrine 1 mg IV/IO every 3–5 minutes
First-line for non-shockable rhythms.
3
Do NOT defibrillate
Shocks are not indicated for asystole or PEA.
4
Search for and treat reversible causes
Reversible cause identification is especially critical in PEA — success depends on it.
5
Reassess rhythm every 2 minutes
If rhythm converts to VF/VT, switch to the shockable algorithm.
Clinical Pearl
In PEA, the heart has organized electrical activity but no mechanical output — the answer is almost always a reversible cause. Think Hs and Ts immediately.
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