Expansion
Two shockable, two non-shockable, and the four Hs and four Ts
Expansion
Shockable
- Ventricular fibrillation
- Pulseless ventricular tachycardia
Non-shockable
- Pulseless electrical activity
- Asystole
Drug timing differs, which is the point most often confused:
- Shockable: adrenaline 1 mg after the third shock, then every 3 to 5 minutes. Amiodarone 300 mg after the third shock, and a further 150 mg after the fifth
- Non-shockable: adrenaline 1 mg immediately, then every 3 to 5 minutes. No amiodarone
Reversible causes: the four Hs and four Ts
- H - Hypoxia
- H - Hypovolaemia
- H - Hypo or hyperkalaemia and metabolic disorders
- H - Hypothermia
- T - Thrombosis, coronary or pulmonary
- T - Tension pneumothorax
- T - Tamponade
- T - Toxins
Compressions at 30:2 with minimal interruption, depth 5 to 6 cm at 100 to 120 per minute, and continuous compressions once the airway is secured. PEA with a very slow rate suggests hypovolaemia, hypoxia or tamponade, and prompts a search rather than more adrenaline.