BLS Adult Cardiac Arrest Algorithm

This algorithm provides a comprehensive guide for managing adult victims of cardiac arrest, emphasizing early recognition, CPR, and the use of an Automated External Defibrillator (AED). It is designed to facilitate prompt and effective resuscitation efforts by bystanders and emergency responders.

Initial Assessment and Activation

Ensure Scene Safety: Always ensure the scene is safe before approaching the victim.

Check Responsiveness: Attempt to wake the victim by shouting and gentle shaking. If there is no response, shout for nearby help.

Activate Emergency Response System (ERS): Instruct someone to call the emergency services and obtain an AED. If alone, make the call yourself.

Assess Breathing and Pulse

Check Pulse and Breathing: Quickly assess the victim’s pulse and breathing for no more than 5-10 seconds. Look for normal breathing, gasping, or no breathing at all.

Immediate Resuscitation Efforts

No Pulse and No Breathing:

• Begin CPR: Start performing CPR using a 30:2 compression-to-ventilation ratio. Continue without interruption.
• Use of AED: As soon as the AED arrives, turn it on and follow the prompts. If the rhythm is shockable, administer one shock and immediately resume CPR for two minutes before the AED rechecks the rhythm.

Irregular Pulse with Abnormal Breathing:

• Rescue Breathing: If there is an irregular pulse and the victim is not breathing adequately, perform rescue breathing at a rate of 1 breath every 5-6 seconds (10-12 breaths per minute).
• Monitor and Support: Continue to check the pulse and provide rescue breaths every two minutes. Activate the ERS if not already done.

Opioid Overdose Consideration

Administer Naloxone: If there is a possibility of an opioid overdose and naloxone is available, administer according to prescribed guidelines.

Continuous Monitoring and Support

Continue CPR and AED Use: If the initial or subsequent rhythm checks with the AED are not shockable, continue performing CPR uninterruptedly until advanced life support (ALS) providers arrive or the victim shows signs of movement.

Transition to Advanced Care

ALS Arrival: Once ALS providers arrive, they will take over and continue advanced resuscitation and post-resuscitation care.