Perfomed by the strongest individual on the code team for the entirety of the resuscitation.
Compressions are performed gently to avoid injury to the patient at a speed that does not exceed 100 compressions/minute.
CPR that is performed hard (at least 2 inches depth), fast (at least 100 compressions/min), and with minimal interruptions (less than 10s).
Recent evidence demonstrates that rescue breathing is more important than chest compressions, and therefore, no chest compressions should be performed.
CPR is perfomed without changes at a ratio of 30 compressions to 2 rescue breaths.
The compression to ventilation ratio is reduced to 15:2.
Compressions are performed at a rate of less than 100 per minute; ventilations are delivered twice every 3-5 seconds.
Compressions are performed at a rate of at least 100 per minute; ventilations are delivered once every 6-8 seconds.
Lay patient in a supine position, confirm the presence of a pulse, and begin to ventilate the patient at a rate of 12/minute.
Immediately administer 0.5 mg Atropine via IV to correct the bradycardia.
Begin CPR at a rate of 30 compressions to 2 rescue breaths.
Apply pads to patient's chest and begin to pace at 70/min.
0.5 mg Atropine, IO
1 mg Epinephrine, IO
300 mg Amiodarone, IO
6 mg Adenosine, IV
Immediately intubate the patient.
Establish IV access and administer 8 mg of naloxone (Narcan).
Reposition the airway and use a simple airway adjunct, evaluate for improved compliance and reduced resistance.
Stop ventilating the patient and start compression only CPR.
DOOM - Digitalis, Oxycodone, Oxygen, Morphine
GNOME - Gabapentin, Nitroglycerine, Oxygen, Milk of Magnesia, Epinephrine
MONA - Morphine, Oxygen, Nitroglycerine, Aspirin
MOAN - Metformin, Ondansetron, Aspirin, Naloxone
Page a cardiologist STAT to assess this patient.
Regard the chest pain as benign since the patient has already been experiencing it for 2 hours and is not displaying any symptoms.
Order a CT scan to rule out a stroke.
Gather a focused history; obtain a 12 lead EKG; obtain blood for laboratory testing. Apply oxygen to maintain SpO2 above 94%.
Ventricular Fibrillation (VFib)
Monomorphic wide complex ventricular tachycardia (VTach)
Polymorphic wide complex ventricular tachycardia (VTach)
Administer tPA to break down the intracerebral clots causing his symptoms.
Obtain a head CT to rule out the possibility of a hemorrhagic stroke.
Obtain a 12 lead EKG and cardiac markers to rule out acute coronary syndromes.
Offer the patient 324 milligrams of aspirin for his headache.