Online ACLS Certification | Advanced Life Support Course

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CARDIAC ARREST ALGORITHM

SHOCKABLE: VF / pVT

Shock (120–200 J biphasic) → CPR 2 min
Epi 1 mg after 2nd shock, then q3–5 min
Amiodarone 300 mg OR Lidocaine 1–1.5 mg/kg
(after 3rd shock if VF/pVT persists)

NON-SHOCKABLE: Asystole / PEA

CPR → Epi 1 mg ASAP → q3–5 min
Treat H’s and T’s aggressively
No shock. Never shock flat line.

KEY DRUG DOSES

Epinephrine:	1 mg IV/IO q3–5 min
Amiodarone:	300 mg IV push
Amiodarone (2nd):	150 mg IV push
Lidocaine:	1–1.5 mg/kg IV/IO
Atropine:	0.5 mg IV, max 3 mg total
Adenosine (1st):	6 mg rapid IV push
Adenosine (2nd/3rd):	12 mg rapid IV push
Magnesium (TdP):	1–2 g IV over 15 min
Naloxone:	0.4–2 mg IM/IV/IN

POST-ROSC TARGETS

SpO2: 94–99%
PaCO2: 35–45 mmHg
Temp: 32–36°C × 24 hr
Glucose: 140–180 mg/dL
MAP: ≥65 mmHg
12-lead ECG: Obtain immediately
STEMI found: Emergent PCI

RHYTHM QUICK GUIDE

VF: Shock
pVT: Shock
Asystole: CPR + Epi
PEA: CPR + Epi
Stable SVT: Adenosine
Unstable Tach: Cardioversion
Bradycardia: Atropine
Torsades: Mg sulfate

STROKE ESSENTIALS

FAST: Face, Arm, Speech, Time
CT: Non-contrast CT head
Door to CT: Within 25 min
Door to needle: Within 60 min
tPA: Up to 3 hr (4.5 selected)
Dose: 0.9 mg/kg IV

SPECIAL SITUATIONS

Pregnancy arrest → PMCD if no ROSC
Manual left uterine displacement
Opioid + apnea → Naloxone
Termination → EtCO2 <10
ECPR → ECMO center

H’s (Reversible Causes)

Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo / Hyperkalemia
Hypothermia

T’s (Reversible Causes)

Tension pneumothorax
Tamponade (cardiac)
Toxins / drug overdose
Thrombosis – pulmonary (PE)
Thrombosis – coronary (MI)

HIGH-YIELD NUMBERS TO MEMORIZE

CPR rate 100–120/min	CPR depth 2–2.4 inches	Epi dose 1 mg q3–5 min	Amio 1st 300 mg	Amio 2nd 150 mg	Atropine max 3 mg
Adenosine 1st 6 mg	TTM 32–36°C × 24 hr	Post-ROSC SpO2 94–99%	Glucose target 140–180	Stroke needle <60 min	PMCD timing 4–5 min

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