Page 265 - PJ MED OPS Handbook 8th Ed

ACLS

Adult ACLS
Further Dosing – Indications
adenosine 6mg IV/IO push IV PUSH in 1–2 seconds to treat SVT, double and
repeat dose up to 2× if no effect
amiodarone 300mg IV/IO over 10min then 150mg q3–5min. To treat pulseless VT/VF.
atropine 1mg IV/IO q3–5min for asystole or bradycardic PEA. For bradycardic
0.4mg. 3mg max.
defibrillation 120J then 150J, then 200J. Repeat after each medication.
cardioversion 75J synchronized then 120J, then 150J.
CaCl 10mg/kg q10min PRN for cardiac arrest with K , Ca, or Ca Channel blocker
+
2
overdose
epinephrine 1mg IV/IO q3–5min for VF/pulseless VT, asystole, and PEA
lidocaine 1–1.5mg/kg IV/IO initial, 0.5–0.75mg/kg after 5–10min; for persistent VF/VT
30–50mcg/kg/min Maximum dose 3mg/kg
infusion
magnesium 1–2g IV in 100mL D 5 W Infuse at 0.5–1g/hr for torsades, Mg or refractory VF
1mEq/kg initial, then Guided by ABG: 0.3 × wt (kg) × base deficit =
NaHCO 3
0.5mEq/kg q10min incremental dose in mEq. Do not mix with
catecholamines or calcium salts. Helpful for
treatment of K +
procainamide 20mg/min IV infusion maximum 17mg/kg, 100mg IVP q5min if in refractory
VF/VT
vasopressin 40U IV/IO/ET × 1 Alternate pressor to epinephrine in Cardiac Arrest
NAVEL (naloxone, atropine, vasopressin, epinephrine, lidocaine) may be given via ETT in 10cc NS, at 2–3 × IV
dose, Vaspressin 1 × IV dose.
Pediatric Code
Further Dosing – Indications
adenosine 0.1mg/kg IV/IO push IV PUSH in 1–2 seconds to treat SVT, double and
repeat dose up to 2× if no effect
amiodarone 5mg/kg IV/IO load over 10minutes for pulseless VT/VF
atropine 0.02mg/kg IV/IO may repeat × 1. 1mg max.
defibrillation 2J/kg initial then 4J/kg × 2. Repeat after each medication.
cardioversion 0.5–1J/kg synchronized
epinephrine 0.01mg/kg IV/IO q3–5min (0.1mL/kg of 1:10,000)
glucose 0.5–1g/kg IV/IO 2–4mL/kg of D25W. Give slowly.
lidocaine 1mg/kg IV/IO may repeat × 1 after 10minutes
magnesium 25–50mg/kg IV/IO for torsades de pointes or hypomagnesemia
1mEq/kg use only with ventilation. Give slowly.
NaHCO 3
volume 10–20mL/kg isotonic (crystalloid). Repeat as guided by vital signs.
Chapter 23. Mnemonics, Conversion Charts and Cheat Sheets n 263