ACLS — VF/Pulseless VT
Ventricular fibrillation and pulseless ventricular tachycardia resuscitation algorithm
Overview
- Ventricular fibrillation and pulseless ventricular tachycardia resuscitation algorithm
Protocol steps
- id: 1; title: Confirm Cardiac Arrest; detail: Unresponsive, no pulse, no breathing. Call for help. Activate code team. Get defibrillator.; time: ; drugs:
- id: 2; title: CPR — High Quality; detail: Rate 100-120/min, depth 2-2.4 inches, full recoil, minimize interruptions. Rotate compressors q2min.; time: 120; drugs:
- id: 3; title: SHOCK 200J; detail: Biphasic defibrillator. Resume CPR immediately after shock — do not pause to check rhythm.; time: ; drugs:
- id: 4; title: CPR 2 Minutes; detail: Continue high-quality CPR. Establish IV/IO access. Prepare epinephrine.; time: 120; drugs: name: Epinephrine; dose: 1mg IV/IO; interval: q3-5min
- id: 5; title: Rhythm Check + SHOCK; detail: If still VF/VT — shock again. Escalate energy if available (200J → 300J → 360J).; time: ; drugs: ; branch: true
- id: 6; title: CPR 2 Minutes + Amiodarone; detail: Continue CPR. Give amiodarone after 3rd shock.; time: 120; drugs: name: Amiodarone; dose: 300mg IV/IO push; interval: then 150mg x1 repeat; name: Epinephrine; dose: 1mg IV/IO; interval: q3-5min (continue)
- id: 7; title: Rhythm Check + SHOCK; detail: If persistent VF/VT, shock again. Consider reversible causes: Hs and Ts.; time: ; drugs: ; branch: true
- id: 8; title: Continue CPR Cycles; detail: Alternate 2-min CPR with rhythm checks and shocks. Continue epinephrine q3-5min. Consider amiodarone 150mg x1. Address Hs and Ts. If ROSC: post-cardiac arrest care.; time: 120; drugs: name: Epinephrine; dose: 1mg IV/IO; interval: q3-5min
Source and review
- AHA ACLS Guidelines 2020; Panchal et al., Circulation 2020. Last reviewed: 2024-11-01