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ACLS Cardiac Arrest Algorithm (VF & pVT)

Updated: Oct 18, 2021

The ACLS Cardiac Arrest Algorithm 2020 focussing on shockable rhythms (VF & pVT) is one of the most important algorithms because we can make a difference in patient outcomes if we respond quickly and effectively.

In today's video, we are focusing on the American Heart Association Cardiac arrests algorithm. We will specifically focus on the shockable rhythms, Ventricular Fibrillation (VF), and Pulseless Ventricular Tachycardia (pVt)

What is the first thing we should do???🤔

⚠️ Focus: High-Quality CPR and



Check responsiveness

-Activate emergency response system

-Check Carotid pulse/ Breathing for 5-

10 seconds

-Call for defibrillator ☎️


⚡️ Assess for VF/ pulseless VT and Defib immediately as per manufacturer recommendation:

-1x 360J (Monophasic)

-1x 120J →150J →200J (Biphasic Rectilinear Zoll )

-1x 150J (Phillips Smart Biphasic)

-1x 200J →300J →360J (LifePak)

High-Quality CPR for 2 minutes ⏱

Review: Persistent VF/ pVT


⚡️Defib Number 2

⚠️ After every defib, resume high-quality CPR without delay.

💉 Epinephrine 1 mg IV push q 3-5 min


⚡️ Defib Number 3:


💉 Amiodarone: 300 mg IV push or Lidocaine: 1 – 1.5 mg/kg IV push


⚡️ Defib Number 4:

💉 Epinephrine 1 mg IV push.


⚡️ Defib Number 5:


💉 Amiodarone: 150mg or Lidocaine: 0.5- 0.75mg/kg.


If you follow this ⚡️-⚡️- Epi -⚡️- Amio -⚡️- Epi- ⚡️- Amio pattern it will mean that you will give 1 Epinephrine every 4 minutes and 1 Amiodarone every 4 minutes.

💡All even number of shocks followed by Epinephrine

💡Uneven number of shocks followed by Amiodarone (Shock 3 & 5 only)

Remember: BLS is the foundation of our ACLS, if we don’t perform good BLS, the chances of us being successful in ACLS diminishes significantly.


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