2-1 ASYSTOLE-PEA
From CRS EMS Guidelines
Revision as of 14:52, 3 April 2022 by Cgabryszek (talk | contribs) (Created page with "'''Any patient requiring ACLS care should have an ALS intercept if logistically possible''' {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Establish unresponsiveness and PNB status # Provide CPR as outlined in the Adult Cardiac Arrest: Cardio-Cerebral Resuscitation Protocol # '''Call for ALS intercept''' # Prepare for transport {| class="wikitable" |'''EMT- Emergency Medical Technician''' ''perform/confirm all above interventions'' |} '''Assure...")
Any patient requiring ACLS care should have an ALS intercept if logistically possible
| EMR - Emergency Medical Responder |
- Establish unresponsiveness and PNB status
- Provide CPR as outlined in the Adult Cardiac Arrest: Cardio-Cerebral Resuscitation Protocol
- Call for ALS intercept
- Prepare for transport
| EMT- Emergency Medical Technician perform/confirm all above interventions |
Assure ALS intercept is en route
- Reassess PNB status, continue Adult Cardiac Arrest: Cardio-Cerebral Resuscitation Protocol
- Transport as early as possible, continuing resuscitation
- Apply ECG monitor & run strip (if trained, if time allows and after all other interventions are completed)
- Perform 12-lead ECG (if trained) as indicated
CONTACT MEDICAL CONTROL
| AEMT – Advanced Emergency Medicine Tech Perform/Confirm All Above Interventions |
- Initiate IV/IO NS, if approved, after 3rd analysis or sooner if possible, without interrupting CPR give NS fluid bolus, 500 mL wide open (do not delay transport)
- CONTACT MEDICAL CONTROL
- Administer additional NS fluid bolus, as directed
| Intermediate perform/confirm all above interventions |
- Attach cardiac monitor if not already done, confirm asystole in more than 1 lead
- Administer epinephrine every 3-5 minutes
- 1 mg of 1:10,000 IV /IO -OR-
- 2 mg 1:1,000 ETT
- Reassess rhythm every 2 minutes with changes in CPR provider or anytime ECG rhythm changes
- Insert Advance Airway (Non-visualized or ETT) if not already done & confirm placement via capnography
- If pulse regained at any time, reassess rhythm & go to appropriate algorithm CONTACT MEDICAL CONTROL
- If persistent asystole, consider quality of resuscitation and termination
| Paramedic perform/confirm all above interventions |
CONTACT MEDICAL CONTROL
- Consider adjunct ACLS medications or antidotes
- Consider causes to focus treatment
- H’s & T’s: Hypovolemia, Hypoxia, H+ acidosis, Hypo/Hyperkalemia, Hypoglycemia, Hypothermia, Toxins, Tamponade, Tension pneumothorax, Thrombosis (coronary, pulmonary), Trauma
