Perform CPR until Defibrillator attached

* Three Sequenced Shocks - No CPR in between.
* Do not delay Defibrillation for IV access.

Click on the Pic to Enlarge
Press "BACK" to return

Presistent or Recurrent VF/VT ?

Repeat every 3-5 min

Within 30-60 sec after each dose of medication

Consider repeat in 3-5 min to
max dose of 3mg/kg

Within 30-60 sec after each dose of medication

Repeat in 5 min at 10mg/kg . Maximum
total dose of 30mg/kg

Within 30-60 sec after each dose of medication

Class IIa in Torsades De Points
and Hypomagnesemia

Within 30-60 sec after each dose of medication

Maximum total dose of 17mg/kg

Within 30-60 sec after each dose of medication

Class I     *If patient has known preexisting Hyperkalemia
Class IIa *Preexisting acidosis           *Tricyclic Antidepressants Overdose
Class IIb  *If intubated and continued long arrest interval
                  *Upon return of spontaneous circulation after long arrest interval

Three sequenced shocks may be repeated between drugs

Upon return of spontaneous circulation -
Lidocaine - Loading dose of 0.5-1mg/kg (total of 2mg/kg), maintenance of 2-4 mg/min
Bretylium - Maintenance of 1-2 mg/min 
Procainamid - 1-4 mg/min

Paramedic Neomi Zvi - Feb 2000

AHA ; ACLS ; 1994 ; 1-15  -  1-21