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ACLS Adult Post Cardiac Arrest Algorithm

Updated: Oct 18, 2021


In today's video, we will be reviewing the ACLS Adult Post Cardiac Arrest Care algorithm that will be used when a patient achieves Return of Spontaneous Circulation or ROSC. We will discuss the ACLS concepts, Targeted Temperature management or TTM, ICU medications, Neuroprognostication to be used.


Is the patient breathing?


Initial Stabilization Phase

•A- Open, Maintain and Protect

•B- Give one breath every 6 seconds (10 per minute)

•B- Advanced Airway with Waveform Capnography (PaCO2 35-45mmHg)

•B- SpO2= 92- 98%


Check Pulse & BP:


•C- Systolic BP is >90mm Hg

•C- Mean Arterial Pressure (MAT) >65mm Hg

•C- Fluid bolus of 1 to 2 L Normal Saline or Ringers Lactate

•C- Unresponsive: Cold Saline to induce TTM for at least 24 hours

•C- Norepinephrine: 0.1 to 0.5 mcg/kg per minute IV Infusion

•C- Epinephrine: 2 to 10 mcg per minute IV infusion

•C- Dopamine: 5 to 20 mcg/kg per minute IV infusion

•C- 12 Lead ECG- Hunting for STEMI or patients requiring a Cathlab

Continued Management & Additional Emergency Activities

•Reversible causes (H’s & T’s)

•Brain CT

•EEG

•Reasonable to perform neuroprognostication at a minimum of 72 hours after normothermia


•For more information review the 2020 Guidelines.

AHA 2020 Guidelines: https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines


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