Page 88 - Radiology Book

asystole algoritHm
Resuscitation sequence is virtually identical to treating slow PEA. Con rm that the atline is not due to operator error. The possible reversible causes of asystole and PEA are the same (5 Hs and 5 Ts).
NO
Follow Universal Algorithm for:
PRIMARY SURVEY - CABD SECONDARY SURVEY - CABD
ASYSTOLE ON MONITOR
HIGH QUALITY CPR
· IV/IO access
· Epinephrine 1 mg IV every 3–5 minutes
· Advanced airway
· Look for reversible causes
· 5 Hs and 5 Ts
RHYTHM CHECK
· After every 2 minutes of CPR · Treat reversible causes
RHYTHM SHOCKABLE? YES
Return of spontaneous circulation
GO TO VF/pVT ALGORITHM
POST-CARDIAC ARREST CARE
ASYSTOLE CONTINUES
When to withhold or cease resuscitative efforts:
· Quality of resuscitation? Effective ventilation, drug therapy, reversible causes ruled out, continuous and documented asystole for more than 5–10 minutes after all of the above have been accomplished.
· Atypical clinical presentation?
· Hypothermia, drowning, drug OD.
· Clinical support for discontinuing resuscitation efforts?
Most Frequent Causes in Differential Diagnosis
5 Hs
· Hypovolemia
· Hypoxia
· Hydrogen ion (acidosis) · Hypo-/hyperkalemia
· Hypothermia
5 Ts
· Toxins (drugs; OD or accidental) · Tamponade, cardiac
· Tension pneumothorax
· Thrombosis, coronary (ACS)
· Thrombosis, pulmonary embolism
Adapted from Circulation. 2015;132:S444-S464
Southfield16
ACLS