¹ CPR quality:
• Push hard (≥1/3 of anteroposterior diameter of chest) and fast (100-120/min), allow complete chest recoil
• Minimize interruptions in compressions
• Change compressor q2min, or sooner if fatigued
• If no advanced airway, 15:2 compression:ventilation ratio
• If advanced airway, provide continuous compressions & give a breath q2-3sec

² Shock energy for defibrillation:
• First shock: 2 J/kg
• Second shock: 4 J/kg
• Subsequent shocks: ≥4 J/kg. Max 10 J/kg or adult dose

³ Drug therapy:
• epinephrine IV/IO dose: 0.01 mg/kg (0.1 mL/kg of the 0.1 mg/mL concentration). Max dose 1 mg. Repeat q3-5min. If no IV/IO access, may give endotracheal dose: 0.1 mg/kg (0.1 mL/kg of the 1 mg/mL concentration).

• amiodarone IV/IO dose: 5 mg/kg bolus during cardiac arrest. May repeat up to 3 total doses for refractory VF/pulseless VT.
OR
• lidocaine IV/IO dose: Initial: 1 mg/kg loading dose.

⁴ Advanced airway:
• Endotracheal intubation or supraglottic advanced airway
• Waveform capnography or capnometry to confirm/monitor ET tube placement
• Once advanced airway in place, give 1 breath q6sec (10/min) w/ continuous chest compressions

⁵ Reversible causes:
• Hypovolemia
• Hypoxia
• Hydrogen ion (acidosis)
• Hypoglycemia
• Hypo/hyper-kalemia
• Hypothermia
• Tension pneumothorax
• Tamponade, cardiac
• Toxins
• Thrombosis, pulmonary
• Thrombosis, coronary

⁶ Return of spontaneous circulation (ROSC) signs:
• Pulse and BP
• Abrupt sustained increase in PETCO2 (typically ≥40 mm Hg)
• Spontaneous arterial pressure waves w/ intra-arterial monitoring

¹ CPR quality:
• Push hard (≥1/3 of anteroposterior diameter of chest) and fast (100-120/min), allow complete chest recoil
• Minimize interruptions in compressions
• Change compressor q2min, or sooner if fatigued
• If no advanced airway, 15:2 compression:ventilation ratio
• If advanced airway, provide continuous compressions & give a breath q2-3sec

² Drug therapy:
• epinephrine IV/IO dose: 0.01 mg/kg (0.1 mL/kg of the 0.1 mg/mL concentration). Max dose 1 mg. Repeat q3-5min. If no IV/IO access, may give endotracheal dose: 0.1 mg/kg (0.1 mL/kg of the 1 mg/mL concentration).

³ Advanced airway:
• Endotracheal intubation or supraglottic advanced airway
• Waveform capnography or capnometry to confirm/monitor ET tube placement
• Once advanced airway in place, give 1 breath q6sec (10/min) w/ continuous chest compressions

⁴ Reversible causes:
• Hypovolemia
• Hypoxia
• Hydrogen ion (acidosis)
• Hypoglycemia
• Hypo/hyper-kalemia
• Hypothermia
• Tension pneumothorax
• Tamponade, cardiac
• Toxins
• Thrombosis, pulmonary
• Thrombosis, coronary

⁵ Return of spontaneous circulation (ROSC) signs:
• Pulse and BP
• Abrupt sustained increase in PETCO2 (typically ≥40 mm Hg)
• Spontaneous arterial pressure waves w/ intra-arterial monitoring

¹ Possible Causes:
• hypothermia
• hypoxia
• medications

² Drug therapy:

• epinephrine IV/IO dose: 0.01 mg/kg (0.1 mL/kg of the 0.1 mg/mL concentration). Repeat every q3-5min. If IV/IO access not available but endotracheal (ET) tube in place, may give ET dose: 0.1 mg/kg (0.1 mL/kg of the 1 mg/mL concentration).

• atropine IV/IO Dose: 0.02 mg/kg. May repeat once. Minimum dose 0.1 mg and max single dose 0.5 mg.

¹ Synchronized cardioversion: Begin w/ 0.5-1 J/kg; if not effective, increase to 2 J/kg. Sedate if needed, but don’t delay cardioversion.

² Drug therapy:
Adenosine IV/IO Dose:
• First dose: 0.1 mg/kg rapid bolus (max: 6 mg)
• Second dose: 0.2 mg/kg rapid bolus (max second dose: 12 mg)