Image: Quincy, Illinois Family Medicine Residency Program
Image: 612 N. 11th, Suite B, Quincy, IL, 62301, 217-224-9484, Fax: 217-224-7950
Email link: quincyfpinfo@siumed.edu
Memory Joggers: ACLS V Fib / Pulseless V Tach for Adults

Reviewed 8-2004
  • Assess responsiveness
  • Active EMS
  • Call for defibrillator
  • Head tilt, chin left, look, listen & feel for breathing
  • Give 2 breaths
  • Look for signs of circulation including a pulse
  • No pulse, start CPR at a rate of 15:2
  • Attach monitor with Quick combo patches
  • Identify rhythm as V fib or pulseless VT
  • Charge to 200 j., clear the table and deliver the shock
  • Reassess rhythm as v fib
  • Charge to 300j., clear the table and deliver the shock
  • Reassess rhythm as v fib
  • Charge to 360j., clear the table and deliver the shock
  • Continue CPR
  • Intubate and confirm with 5 point auscultation & end CO2 detector (if available)
  • Start IV in antecubital with large angio cath
  • Attach monitor leads
  • Epinephrine 1mg. IV push, repeat every 3-5 min. (May use Vasopressin 40 Units IV once instead of Epinephrine. Must wait 10 minutes before giving Epinephrine.)
  • Check pulse. Contiue CPR
  • Defribillate 360 J within 30-60 seconds
  • Check pulse. Continue CPR
  • Lidocaine 1.0-1.5 mg/kg IV push, Consider repeat dose of 0.5-0.75mg/kg every 5-10 min to a maximum dose of 3 mg/kg. (May choose to use Amiodarone instead of Lidocaine. Amiodarone dose is 300mg IVP. May use a repeat dose of 150mg in 5-10min.)
  • Check pulse, continue CPR
  • Defibrillate 360 J
  • Check pulse, continue CPR
  • Consider Magnesium sulfate 1-2 g IV in torsades de pointes or known hypomagnesic state of refractory VF
  • Sodium bicarbonate mmEq/kg IV for acidosis or tricyclic antidepressant overdose. Ventilate patient well.

To: ACLS Intravenous Medicated Infusions

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