Ventilation should be provided at 10 to 12 breaths per minute, with attention to avoid overventilation.
If an AED or monitor is available, assess for a shockable rhythm (VF/VT) and defibrillate with 2 joules per kg as the initial dose, followed by doubling to 4 joules per kg if this is not achieved. If the rhythm is shockable, continue with 2-minute cycles of chest compressions, followed by a single shock.
Consider giving epinephrine every 3 to 5 minutes, and malaysia email list if VF/VT persists, consider amiodarone 5 mg/kg IV or IO, followed by circulating the drug with CPR and then a shock to defibrillate.
Alternative medications include lidocaine or vasopressin, but amiodarone is preferred.
If the rhythm is not shockable, continue excellent CPR with the addition of epinephrine 10 mcg/kg IV/IO every 3 to 5 minutes. Higher doses of epinephrine have not been shown to be helpful and are potentially harmful.
Assess CPR quality (depth, rate, total delivery, ventilation) to achieve a diastolic BP of 30 mm Hg and end-tidal CO2 of >15 mm Hg. End-tidal CO2 often reflects CPR quality (e.g. correlated with pulmonary blood flow), and thus may provide a goal-directed target. These targets have been associated with improved return of spontaneous circulation in animals and adults.
