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Cardiac Arrest: Non-Shockable - #PHARMFAX

Non-shockable cardiac arrest are non-perfusing rhythms defined by absent or insufficient ventricular response.

 

Non-shockable cardiac arrest are non-perfusing rhythms defined by absent or insufficient ventricular response. Pulseless electrical activity (PEA) and asystole are non-shockable rhythms with limited ACLS-specific interventions and we’ll work on the right branch of the algorithm.


Metabolic abnormalities and acidosis lead to cardiovascular injury and PEA. Asystole is a poor indication of prognosis since its more of a later manifestation of VF/pVT/PEA. CPR is the mainstay of therapy, and unlike shockable arrhythmias, early administration of epinephrine after CPR is recommended. Continuous CPR with EPI 1 mg every 3 to 5 minutes is the cycle for non-shockable rhythms. With all CA and standard ACLS measures, we need to consider reversible causes and increase the likelihood of a successful resuscitation.


H include hypovolemia, hypoxia, hypothermia, hypo/hyperkalemia, and hydrogen ions. T’s include thrombosis (cardiac), thrombosis (pulmonary), cardiac tamponade, tension pneumothorax, and toxins. Definitive therapy for reversible causes may include blood transfusions, electrolyte correction such as utilizing the acute hyperkalemia cocktail, reperfusion via systemic thrombolytics, and needle decompression. High quality CPR maintains blood flow, perfuses vital organs, and increases rates of ROSC. Limit interruptions in CPR and when in doubt, its better to give CPR than not. For more PHARMFAX in the drug bank, I’d appreciate a follow, share with a friend, and I hope you learned something new.




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Not medical advice. Educational purposes only. No relationships to report. I hope you learned something new.

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