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Rapid treatment of VF using the pulseless arrest algorithm has been established as the
best scientific approach to restoring spontaneous circulation.
There are several important points that should be considered when initiating the
pulseless arrest algorithm:
High-quality CPR should be performed until the defibrillator is attached the
patient.
Interruptions in chest compressions should be kept to a minimum.
Rapid use of the defibrillator should be emphasized.
If possible, use a manual defibrillator over an AED since the use of the AED can
result in prolonged interruptions in chest compressions for rhythm analysis and shock
administration.
No longer are stacked shocks used. CPR is resumed for 5 cycles between each shock.
To ensure safety during the shock, providers should always announce the following
statement, I am going to shock on three. One, Im clearTwo, youre clearThree,
everybody is clear.
Do you know the difference between defibrillation, synchronized cardioversion, and
unsynchronized cardioversion? Find out here.
Vasopressors
A vasopressor is a medication that produces vasoconstriction and a rise in blood
pressure. The vasopressors that can be used in the treatment of VF/Pulseless VT are
epinephrine and/or vasopressin.Epinephrine is primarily used for is vasoconstrictive
effects. Vasoconstriction is important during CPR because it will help increase blood
flow to the brain and heart. Vasopressin is also used for its vasoconstrictive effects and
has been shown to have effects similar to those of epinephrine.
Rhythm checks should be performed after 5 cycles of CPR. Limit rhythm checks to less
than 10 seconds to minimize interruptions in CPR
Antiarrhythmic Drugs
Amiodarone, lidocaine, and magnesium are antiarrhythmic medications that are used in
the pulseless arrest algorithm. To learn more detailed information about these
medications go here.