A
ACE
Angiotensin-converting enzyme
ACLS
Advanced cardiovascular life support
ACS
Acute coronary syndromes
AED
Automated external defibrillator
AHF
Acute heart failure
AIVR
Accelerated idioventricular rhythm
AMI
Acute myocardial infarction
aPTT
Activated partial thromboplastin time
AV
Atrioventricular
B
BLS
Basic life support: Check responsiveness, activate emergency response system, check carotid pulse, provide defibrillation
C
CARES
Cardiac Arrest Registry to Enhance Survival
CCF
Chest compression fraction
CPR
Cardiopulmonary resuscitation
CPSS
Cincinnati Prehospital Stroke Scale
CQI
Continuous quality improvement
CT
Computed tomography
D
DNAR
Do not attempt resuscitation
E
ECG
Electrocardiogram
ED
Emergency department
EMS
Emergency medical services
ET
Endotracheal
F
FDA
Food and Drug Administration
FIO2
Fraction of inspired oxygen
G
GI
Gastrointestinal
I
ICU
Intensive care unit
INR
International normalized ratio
IO
Intraosseous
IV
Intravenous
L
LV
Left ventricle or left ventricular
M
mA
Milliamperes
MACE
Major adverse cardiac events
MET
Medical emergency team
MI
Myocardial infarction
mm Hg
Millimeters of mercury
N
NIH
National Institutes of Health
NIHSS
National Institutes of Health Stroke Scale
NINDS
National Institute of Neurological Disorders and Stroke
NPA
Nasopharyngeal airway
NSAID
Nonsteroidal anti-inflammatory drug
NSTE-ACS
Non–ST-segment elevation acute coronary syndromes
NSTEMI
Non–ST-segment elevation myocardial infarction
O
OPA
Oropharyngeal airway
P
PaCO2
Partial pressure of carbon dioxide in arterial blood
PCI
Percutaneous coronary intervention
PE
Pulmonary embolism
PEA
Pulseless electrical activity
PETCO2
Partial pressure of end-tidal carbon dioxide
PT
Prothrombin time
pVT
Pulseless ventricular tachycardia
R
ROSC
Return of spontaneous circulation
RRT
Rapid response team
rtPA
Recombinant tissue plasminogen activator
RV
Right ventricle or right ventricular
S
SBP
Systolic blood pressure
STEMI
ST-segment elevation myocardial infarction
SVT
Supraventricular tachycardia
T
TCP
Transcutaneous pacing
TTM
Targeted temperature management
U
UA
Unstable angina
V
VF
Ventricular fibrillation
VT
Ventricular tachycardia
In the event of a cardiac arrest, follow these CPR guidelines. For more free resources like our ACLS cardiac arrest algorithm, explore other online articles to sharpen your life-saving skills.
Note: These guidelines are for an adult cardiac arrest algorithm. Review guidelines for the pediatric cardiac arrest algorithm with our free resources.
- Start CPR. Start CPR with hard and fast compressions, around 100 to 120 per minute, allowing the chest to completely recoil. Give the patient oxygen and attach a monitor or defibrillator. Make sure to minimize interruptions in chest compressions and avoid excessive ventilation, using a 30 to 2 compression-to-ventilation ratio if no airway is established.
- Rhythm shockable? Conduct a rhythm check, making sure the pause in chest compressions is not more than 10 seconds.
- VF/pVT (Shockable rhythm). If a shockable rhythm is present, either v-fib or pulseless v-tach, begin the charging sequence on the defibrillator and resume chest compressions until the defibrillator is charged.
- Shock. When the defibrillator is charged, announce the shock warning and make sure no one is touching the patient. Shock the patient with an initial dose of 120 to 200 joules.
- CPR – 2 min. Immediately resume CPR for 2 minutes, and establish IV access.
- Rhythm Shockable? Check for pulse and rhythm for no more than 10 seconds every 2 minutes.
- No. If the patient shows signs of return of spontaneous circulation, or ROSC, administer post-cardiac care. If a nonshockable rhythm is present and there is no pulse, continue with CPR and move to the algorithm for asystole or PEA.
- Yes – Shock. If the rhythm is shockable, announce the shock warning and make sure no one is touching the patient. Administer the shock.
- CPR – 2 min. Continue with CPR for 2 minutes. Give the patient a vasopressor such as epinephrine every 3 to 5 minutes, and consider advanced airway and capnography, giving 1 breath every 6 seconds once the advanced airway is in place.
- Rhythm Shockable? Check for pulse and rhythm for no more than 10 seconds every 2 minutes.
- No. If the patient shows signs of return of spontaneous circulation, or ROSC, administer post-cardiac care. If a nonshockable rhythm is present and there is no pulse, continue with CPR and move to the algorithm for asystole or PEA.
- Yes – Shock. If the rhythm is shockable, announce the shock warning and make sure no one is touching the patient. Administer the shock.
- CPR – 2 min. Continue with CPR for 2 minutes. Consider giving the patient an antiarrhythmic drug such as amiodarone for refractory v-fib or pulseless v-tach, and treat reversible causes. Use Hs and Ts to remember: hypovolemic, hypoxia, hydrogen ions, hypo and hyperkalemia, hypothermia, tension pneumo, tamponade, toxins, and thrombosis.
- Asystole/PEA. If a nonshockable rhythm
is present, and the rhythm is organized, check for a pulse. Make sure the pause in chest compressions to check the rhythm is not more than 10 seconds.
- CPR – 2 min. Continue with CPR for 2 minutes, and establish IV access. Give the patient a vasopressor such as epinephrine every 3 to 5 minutes, and consider advanced airway and capnography, giving 1 breath every 6 seconds once the advanced airway is in place.
- Rhythm Shockable? Check for pulse and
rhythm for no more than 10 seconds every 2 minutes.
- Yes. If the rhythm changes to a V-fib or V-tach shockable rhythm, move to that algorithm and prepare to shock the patient.
- CPR – 2 min. If a nonshockable rhythm is still present with no pulse, continue with CPR for 2 minutes, and treat reversible causes. Use Hs and Ts to remember: hypovolemic, hypoxia, hydrogen ions, hypo and hyperkalemia, hypothermia, tension pneumo, tamponade, toxins, and thrombosis.
- Rhythm Shockable? Check for pulse and rhythm for no more than 10 seconds every 2 minutes.
- Yes. If the rhythm changes to a V-fib or V-tach shockable rhythm, move to that algorithm and prepare to shock the patient.
- CPR – 2 min. If the patient shows signs of return of spontaneous circulation, or ROSC, administer post-cardiac care. If a nonshockable rhythm is present and there is no pulse, continue with CPR.