Cardiac Arrest Medications-Epinephrine is First!

Cardiac Arrest Medications-Epinephrine is First!

When dealing with our protocols, you blend them together as much as needed and always use the Airway and ventilation protocol initially.  For patients in cardiac arrest, you should use the cardiac arrest protocol as the primary one and incorporate the others as you have time and personnel.  Our protocols match the current ACLS and AHA guidelines so there are no differences.

This means that after establishing an airway, if a patient is in cardiac arrest, you should go directly to the Cardiac Arrest protocol if you are going to attempt resuscitation.

The cardiac arrest protocol then proceeds to CPR, AED and breaks down into shockable or not.

After oxygen and any saline that you use establishing an IV/IO, the very first medication is always epinephrine (epi).  Epi should be administered consistently every 3-5 minutes thereafter.  If in a shockable rhythm, defibrillation and amiodarone will soon follow.

Once you have initiated these items, you can consider blending in other protocols as time and resources allow.  Dialysis patients may receive bicarb and calcium, patients may receive fluid boluses or  a diabetic patient may require dextrose if their blood glucose is less than 60 mg/dL.

Narcan and and bicarb/calcium should not be administered prior to epinephrine in cardiac arrest.

Here are some additional links regarding cardiac arrest:

https://www.vbems.com/2017/07/17/cardiac-arrest-and-sodium-bicarbonate-use/

https://www.vbems.com/2017/09/02/cardiac-arrest-standing-orders-vs-physician-orders/

https://www.vbems.com/2017/06/26/dnr-what-treatments-can-i-do/

https://www.vbems.com/2017/05/16/dnr-ddnr-advanced-directive-living-will-physician-order-which-one-can-i-use/

https://www.vbems.com/2017/10/23/hospice-patients-how-to-help/