8-Adult Advanced Life Support Algorithm 2021

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Adult advanced life support

Unresponsive and
Maintain
personal not breathing normally
safety

Call resuscitation
team/ambulance

CPR 30:2
Attach defibrillator/monitor

Assess rhythm

SHOCKABLE NON-SHOCKABLE
(VF/Pulseless VT) (PEA/Asystole)
Return of spontaneous
circulation
(ROSC)
1 shock

Immediately resume Immediately resume


CPR for 2 min CPR for 2 min

Give high-quality Identify and treat Consider After ROSC


chest compressions, reversible causes • Coronary angiography/ • Use an ABCDE approach
percutaneous coronary
and: • Hypoxia
intervention
• Aim for SpO2 of 94–98% and
• Hypovolaemia normal PaCO2
• Give oxygen • Mechanical chest
• Use waveform capnography • Hypo-/hyperkalaemia/ compressions to facilitate • 12-lead ECG
• Continuous compressions if metabolic transfer/treatment • Identify and treat cause
advanced airway • Hypo/hyperthermia • Extracorporeal CPR
• Targeted temperature
• Minimise interruptions • Thrombosis – coronary or management
to compressions pulmonary
• Intravenous or intraosseous • Tension pneumothorax
access • Tamponade – cardiac
• Give adrenaline every • Toxins
3–5 min
Consider ultrasound imaging
• Give amiodarone after to identify reversible causes
3 shocks
• Identify and treat reversible
causes

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