■ Hypovolemia
■ Hypothermia
■ Hypoxia
■ Hypoglycemia
■ Acidosis
■ Electrolyte disturbances
■ Cardiac tamponade
■ Overdoses
■ Tension pneumothorax
■ Massive PE
■ MI
ECG FINDINGS
■ Will vary with underlying cause and duration of systemic abnormality
■ Hyperkalemia →sinusoidal rhythm.
■ Hypovolemia or tamponade →marked sinus tachycardia.
■ Severe acidosis or hypoxia →bradyasystolic rhythm.
■ ACS→idioventricular rhythm.
TREATMENT
■ Administer immediate CPR and limit interruptions in CPR.
■ Provide O 2 via BVM, when available, but do not delay CPR.
■ Treat reversible causes, as for PEA (see page 40).
■ Epinephrine IV/IO repeated 3–5 minutes or
a single dose of vasopressin IV/IO may be substituted for the first or second
epinephrine.
■ Consider atropine 1 mg IV/IO if rate is slow.
■ Repeat every 3–5 minutes for three doses.
■ Intermittently assess for return of pulse or presence of shockable rhythm.
ASYSTOLE
Asystole is generally considered a preterminal rhythm. Survival from asystole is
extremely poor.
TREATMENT
■ Consider similar reversible causes as for PEA (see page 40).
■ Treatment is as for PEA.
Cardiac Arrest Medications (See Table 1.10)
Route of administration:
■ Themost rapidly available routeshould be used.
■ Central venous access?
■ Provides the fastest drug delivery to the central circulation, but
■ Notpreferred because of required delay in CPR and/or defibrillation
during line placement
■ Use if no other access available.
■ Peripherally administered drugs should be followed by 20 mL flush and
elevation of extremity.
■ Endotracheal administration
RESUSCITATION
The 6 Hs and 5 Ts
of PEA:
Hypoxia
Hydrogen ion overload
(acidosis)
Hyperkalemia/
hypokalemia
Hypoglycemia
Hypothermia
Hypovolemia
Toxins
Tamponade (cardiac)
Tension pneumothorax
Thromboembolism (PE)
Thrombosis (coronary)A single dose of vasopressin
may be substituted for the first
or second dose of
epinephrine.