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Medication for pulseless electrical activity12/30/2023 ![]() ![]() You should switch to IO is access cannot be gained in under two minutes. Establish intravenous (IV) access and take bloods including a venous blood gas (VBG)If IV access fails, use intraosseous (IO) access.Once a definitive airway has been established, compressions and ventilations can be delivered continuously and simultaneously.Consider airway adjuncts, supraglotic airway devices and definitive airways such as an endotracheal tube.Ensure good quality CPR with minimal interruptions.If a shockable rhythm is identified during a rhythm check, switch to the shockable algorithm but continue giving adrenaline after alternate rhythm checks: do not withhold until after the third shock.After the third rhythm check, given adrenaline 1 mg IV (10 ml of 1:10,000) continue giving adrenaline after alternate rhythm checks ie fifth, seventh, ninth, eleventh etc.After two minutes, pause CPR to check the rhythm on recognising asystole, resume chest compressions immediately and continue for two minutes on recognising organised electrical activity, seek evidence of ROSC and if absent (PEA), resume chest compressions immediately and continue for two minutes.After the first rhythm check, give adrenaline 1 mg IV (10 ml of 1:10,000).On recognising organised electrical activity, seek evidence of ROSC and if absent (PEA), resume chest compressions immediately and continue for two minutes.On recognising asystole, resume chest compressions immediately and continue for two minutes.Management of non-shockable rhythms (asystole or PEA) If asystole is recognised during a rhythm check, switch to the non-shockable algorithm.Iif absent (PEA), resume CPR immediately and switch to the non-shockable algorithm.If present, commence post-resuscitation care.If organised electrical activity is seen during a rhythm check, seek evidence of return of spontaneous circulation (ROSC). ![]() Continue giving adrenaline after alternate shocks ie fifth, seventh, ninth, eleventh etc.After the third shock, give adrenaline 1 mg IV (10 ml of 1:10,000) and amiodarone 300 mg IV.Once the defibrillator is charged, instruct the individual performing chest compressions to stand clear and then deliver the third shock.Once the defibrillator is charged, instruct the individual performing chest compressions to stand clear and then deliver the second shock.Warn all other individuals to stand clear and remove any oxygen delivery device whilst the defibrillator is charged to 150 J. ![]() After two minutes, pause CPR to check the rhythm on recognising a shockable rhythm, resume chest compressions immediately.Resume CPR immediately and continue for two minutes. ![]()
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