Asystole
PEA
Bradycardia
VFib or Pulseless VT
VT with pulse (stable)
SVT
AFib/A-Flutter 
O2, IV, Monitor
O2, IV, Monitor
O2, IV, Monitor
O2, IV, Monitor
O2, IV, Monitor
O2, IV, Monitor
O2, IV, Monitor
no shock (confirm other axis)
no shock
Atropine 0.5mg every 3 to 5 mins, max 3mg.
Shock 360J
Lidocaine 0.5 to 0.75 mg/kg, second dose 1.0 to 1.5 mg/kg, max 3mg
If unstable: Immediate Cardioversion (consider 50J), 100J, 200J, 300J, 360J
Cardizem (stable dose: 0.25mg/kg then 0.35mg/kg)
EPI 1mg (1:10,000) every 3 to 5 mins, no max
EPI 1mg (1:10,000) every 3 to 5 mins, no max
Pace
EPI 1mg (1:10,000) every 3 to 5 mins, no max
If lidocaine fails then consider: Amiodarone 150mg in 100cc over 10 mins.
Attempt vagal maneuvers ... Adenosine 6mg, 12mg, 12mg
Consider Amiodarone 150mg in 100cc over 10 min.


Dopamine drip 2 to 10 mcg/kg/min
Amiodarone 300mg IV, second dose 150mg
 For Torsades only: Magnesium 1 to 2 gm in 100cc D5W over 5 to 60 mins
Cardizem 0.25mg/kg then 0.35mg/kg
Consider cardioversion if unstable and onset <48 hours 
Consider Vasopressin 40 units in place of 1st or 2nd EPI. 
Consider Vasopressin 40 units in place of 1st or 2nd EPI.
EPI drip 2 to 10 mcg/min
Lidocaine 1.0 to 1.5 mg/kg, second dose 0.5 to 0.75 mg/kg, max 3mg
If pt. becomes unstable: synchronized Cardioversion 100J
For wide complex SVT only: Amiodarone 150mg in 100cc over 10 mins.
 
 
 
 
Magnesium 1 to 2 gm in 10cc D5W over 5 to 10 mins
 
 
 
-Ruleouts-
-Ruleouts-
 
BiCarb 1meq/kg IV push
 
 
 

If ROSC: Advanced airway, capnography, induced hypothermia.

If ROSC: Advanced airway, capnography, induced hypothermia.

If ROSC: Advanced airway, capnography, induced hypothermia.







Asystole
O2, IV, Monitor
Epi 1mg (1:10,000) every 3 to 5 mins
Consider Vasopressin 40 units in place of 1st or 2nd EPI.
-Ruleouts-
EG: consider BiCarb for acidotic state
If ROSC: Advanced airway, capnography, induced hypothermia.
 
PEA
O2, IV, Monitor
Epi 1mg (1:10,000) every 3 to 5 mins
Consider Vasopressin 40 units in place of 1st or 2nd EPI.
-Ruleouts-
If ROSC: Advanced airway, capnography, induced hypothermia.
 
Bradycardia
O2, IV, Monitor
Fluid
Atropine 0.5mg every 3 to 5 mins, max 3mg.
Pacing
Dopamine drip 2 to 10 mcg/kg/min
Epi drip 2 to 10 mcg/min
 
VFib/Pulseless Vtach
O2, IV, Monitor
Shock 360J
Epi 1mg (1:10,000) every 3 to 5 mins
Amiodarone 300mg IV push second dose 150mg
Lidocaine 1.0 to 1.5 mg/kg second dose 0.5 to 0.75 mg/kg, max 3mg
Magnesium 1 to 2 gm in 10cc D5W over 5 to 10 mins
BiCarb 1meq/kg IV push
If ROSC: Advanced airway, capnography, induced hypothermia.

Vtach with pulse (stable)
O2, IV, Monitor
Lidocaine 0.5 to 0.75 mg/kg second dose 1.0 to 1.5 mg/kg, max 3mg
If Lidocaine fails then consider Amiodarone 150mg in 100cc over 10 mins
For Torsades only: Magnesium 1 to 2 gm in 100cc D5W over 5 to 60 mins
If pt. becomes unstable: synchronized Cardioversion 100J

 
SVT
O2, IV, Monitor
Immediate Cardioversion if unstable (consider 50J), 100J, 200J, 300J, 360J
Adenosine 6mg, 12mg, 12mg
Cardizem 0.25mg/kg then 0.35mg/kg
For wide complex SVT only: Amiodarone 150mg in 100cc over 10 mins
 
AFib/A-Flutter
O2, IV, Monitor
Cardizem (stable dose: 0.25mg/kg then 0.35mg/kg)
Consider Amiodarone 150mg in 100cc over 10 min.
Cardioversion (consider 50J), 100J, 200J, 300J, 360J

 
CHF
O2, IV, Monitor
Nitro 0.4mg SL (if BP > 110) max 3 tabs
Morphine 2 to 4mg max 10
Lasix double pt's dose or 40mg
CPAP
 
Unconscious
O2, IV, Monitor
Thiamine 100mg
D50 25gm
Narcan 0.4 to 2.0mg titrated to respiratory effect
 
Asthma
O2, IV, Monitor
Albuterol 2.5mg in 3cc NS
Albuterol 2.5mg/Atrovent 0.5mg
EPI 0.3mg SQ
Mag Sulfate IV 1-2 grams over 5 to 10 min
Solu Medrol 125mg
 
Anaphylactic Shock
O2, IV
EPI 0.3mg SQ
Benadryl 25 to 50mg
Albuterol 2.5mg in 3cc NS
Solu Medrol 125mg
Fluid
 
Chest Pain
O2, IV, Monitor
ASA 324mg
Nitro (if BP>110) 0.4mg SL max 3
Morphine (if BP>100) 2 to 4 mg max 10mg