Basic Life Support Provider Algorithm

No movement or response
Phone 911 or emergency number and get AED
Open airway, check breathing-if not breathing give 2 breaths that make chest rise
If no response, check pulse: do you definitely feel pulse within 10 seconds?
If pulse detected, give 1 breath every 5-6 seconds and recheck pulse every 2 minutes
If no pulse, give 30 chest compressions and 2 breaths until AED/defibrillator arrives, ALS providers take over, or victim
starts to move Push hard and fast (100/min) and release completely. Minimize interruption in compressions
AED/defibrillator arrives-check rhythm for shockable rhythm
If shockable rhythm, give 1 shock and resume CPR immediately for 5 cycles
If not shockable rhythm, resume CPR immediately for 5 cycles, check rhythm every 5 cycles, continue until ALS providers take over or victim starts to move
Pulsless Arrest
BLS algorhithm, call for help, give CPR
Give oxygen when available
Attach monitor/defibrillator when available
Check rhythm-shockable rhythm?
Shockable rhythm: Go to VT/VF algorhithm
Not shockable rhythm: Go to Asystole/PEA algorithm
VT/VF Algorithm:
Give 1 shock
Manual biphasic: device specific
(typically 120-200 J)
Note: if unknown, use 200 J
AED: device specific
Monophasic: 360 J
Resume CPR immediately-give 3 cycles of CPR, then check rhythm
Not Shockable rhythm-if asystole, go to Asystole/PEA algorhithm; if electrical activity, check pulse-if pulse, go to
Asystole/PEA algorhithm; if pulse present, begin post-resuscitatioin care
If shockable rhythm-continue CPR while defibrillator is charging
Give 1 shock same as before, resume CPR immediately after shock
When IV/IO available, give vasopressor during CPR (before or after the shock)-Epinephrine 1 mg IV/IO, repeat every
3-5 minutes or Vasopressin (one time dose) 40 U IV/IO to replace first or second dose of epinephrine
Give 5 cycles of CPR, then check rhythm
Shockable rhythm?
Not shockable rhythm: go to Asystole/PEA algorhithm; if electrical activity, but no pulse-go to Asystole/PEA
algorhithm; if electrical activity and pulse present-begin post-resuscitation care
Shockable rhythm:
Continue CPR while defibrillator is charging
Give 1 shock as before, then resume CPR immediately after the shock
Consider antiarrhythmics;give during CPR (before or after the shock)
Amiodarone 300 mg IV/IO once, then consider additional 150 mg IV/IO once, or Lidocaine 1-1.5 mg/kg IV/IO first dose, then 0.5-0.75 mg/kg IV/IO, maximum 3 doses or 3 mg/kg
Consider Magnesium, loading dose 1-2 grams IV/IO for torsades de pointes
After 5 cycles of CPR, check rhythm
Tachycardia With Pulses
Assess and support ABC