ADVANCE CARDIAC LIFE SUPPORT :

ASYSTOLE ALGORITHM

Pembimbing :
dr. Dedi Fitri Yadi, Sp.An, KAR, M.Kes

Oleh :
dr. Ade Novita

ALLPPT.com _ Free PowerPoint Templates, Diagrams and Charts

Adult Cardiac Arrest Algorithm

• High Quality CPR

• Shock Energy for
Defibrillation
• Drug Therapy
• Advanced Airway
• Reversible Causes
HIGH QUALITY CPR
Chest Compression Fraction >80%
Push hard and fast (depth at least 2”, rate 100-120/mnt,
allow chest recoil)
Minimize interruptions

Avoid excessive ventilation

Change compressor every 2 minutes,

If no advanced airway, 30:2 compression-ventilation ratio,

or 1 breath every 6 seconds
ASISTOL

ASYSTOLE
RATE P WAVE PR INTERVAL QRS
REGULARITY
• The rhythm will • The rhythm will • There are no P • PR interval is • There are no
be a nearly flat be a nearly flat waves present. unable to be QRS complexes
line. line. measured due to present.
no P waves be-
ing present.

TRUE ASISTOL
•Check lead and cable connections
•Monitor power on?
•Monitor gain up?
•Verify asystole in another lead?
Drug Therapy
Epinephrine

Repeat doses every 3–5 min as necessary.

An infusion of epinephrine (eg., 1 mg in 250 mL D5W or

NS, 4 mcg/mL) can be titrated to effect in adults (1–4
mcg/ min) or children (0.1–1 mcg/kg/min).

Administration down a tracheal tube requires higher

doses (2–2.5 mg in adults, 0.1 mg/kg in children).

High-dose epinephrine (0.1 mg/kg) in adults is recom-

mended only after standard therapy has failed.
Advanced Airway
Tracheal intubation
Tracheal intubation should be attempted as soon as practical.

Do not interrupt ventilation for more than 10 s.

After intubation, the patient can be ventilated with a selfinflating bag ca-
pable of delivering high oxygen concentrations.

Because two hands are now available to squeeze the bag, ventilation
should be satisfactory

A ratio of 8–10 breaths/min in a secure airway should be maintained, as

high
respiratory rates can impede cardiac output in a cardiac arrest situation.

Wavefrom Capnography or capnometry to confirm and monitor ETT tube

placement
Reversible Causes
5H 5T

• Hypovolemia • Toxins
• Hypoxia • Tamponade Cardia
• Hydrogen ion • Tension pneumothorax
• Hyper / Hypokalemia • Thrombosis coronary (ACS)
• Hypothermia • Thrombosis pulmonary (em-
bolism)
When to stop?
Arrest not witnessed
No bystander CPR
No return of spontaneous circulation
(before transport) No shock was de-
livered (before transport)

If all criteria are present, consider If any criteria are missing, continue
termination of resuscitation resuscitation and transport
THANK YOU