V. fib/Pulsless


	V-FIB and PULSLESS V-TACH a) V-Fib CPR until defibrillator available ¯ Defibrillate 200 J ¯ Defibrillate 200 - 300 J ¯ Defibrillate 360 J ¯ Intubate, IV, CPR ¯ Epinephrine 1 mg IV/ET q3-5 minutes or 1-3-5 mg or 7mg or Vasopressin 40 U IV single dose, 1 time only ¯ Defibrillate 360 J after each drug dose ¯ Amiodarone 300mg IV bolus ¯ Defibrillate 360 J after each drug dose ¯ Lidocaine 1.5 mg/kg IV q3-5 minutes to max 3 mg/kg ¯ Defibrillate 360J ¯ Procainamide 30mg/min IV to max 17 mg/kg ¯ Consider Buffers, Consider Magnesium (if hypomagnesemia). Note: Medications when employed by ETT route are doubled in dose. b) Unstable V. Tach (C.P, CHF, Syncope, +ve pulse) O2, IV, Sedate (if possible) ¯ Synchronized Cardioversion with 100 J ¯ 100 – 200 – 300 - 360 J if no response to above c) Stable. V. Tach - Monomorphic Airway, oxygen, IV ¯ Lidocaine 1 .5 mg/kg IV then 0.5-0.15 mg/kg IV q5-10 min to total 3 mg/kg or Amiodarone 150mg IV over 10 min ¯ Procainamide 20-30 mg/min to max 17 mg/kg ¯ Consider sync. cardioversion with --100, 200, 300 J d) Stable V.Tach – Polymorphic Normal Baseline QT B-blocker or Amiodarone or Lidocaine or Procainamide Then Use Synchronized Cardioversion Long Baseline QT Magnesium ¯ Overdrive Pacing ¯ Isopreterenol

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