Term
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Definition
P E A
Letter Intervention
P Problem search (see Differential Diagnosis Table).
Treat accordingly. Continue this algorithm if
indicated.
E Epinephrine 1 mg IV/IO q3-5 min. Or vasopressin 40 U
IV/IO, once, in place of the 1st or 2nd dose of epi.
A Atropine, with a slow heart rate, 1 mg IV/IO q3-5 min.
(3mg max.)
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Term
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Definition
Oh Say It Isn't So
Mnemonic Preparation
Oh O2 Saturation monitor
Say Suctioning equipment
It IV line
Isn't Intubation equipment
So Sedation and possibly analgesics
Synchronized Electrical Cardioversion *Energy Levels:
The initial synchronized shock is 100J monophasic (50J for SVT/A-Flutter) with increasing energy, i.e., 200J, 300J, 360J, if successive shocks are needed.
Unsynchronized Electrical Cardioversion
Give unsynchronized shocks at VF/PVT *energy levels without delay for unstable tachycardia with critical circulatory compromise due to the fast rate. Also give unsynchronized shocks if you cannot synchronize, or if polymorphic VT is present.
If VF/PVT develops, immediately defibrillate at *360J per the VF/PVT Algorithm.
*Or biphasic equivalent |
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Term
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Definition
P E A
Letter Intervention
P Problem search (see Differential Diagnosis Table).
Treat accordingly. Continue this algorithm if
indicated.
E Epinephrine 1 mg IV/IO q3-5 min. Or vasopressin 40 U
IV/IO, once, in place of the 1st or 2nd dose of epi.
A Atropine 1 mg IV/IO q3-5 min. (3mg max.)
Consider termination of efforts if asystole persists despite appropriate interventions. |
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Term
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Definition
*Pacing Always Ends Danger
Mnemonic Intervention Note
Pacing **TCP Immediately prepare for
transcutaneous pacing (TCP) with
serious circulatory compromise due to
bradycardia (especially high-degree
blocks) or if atopine failed to
increase rate.
Consider medications while pacing is
readied.
Always Atropine 1st-line drug, 0.5 mg IV/IO q3-5 min.
(max. 3mg)
Ends Epinephrine 2-10 µg/min 2nd-line drugs to
consider if atropine and/or TCP are
ineffective. Use with extreme
caution.
Danger Dopamine 2-10 µg/kg/min
*Pacing does not "always end danger" in bradyarrhythmias. If the above measures do not improve circulatory stability the bradycardia may merely be an indication of a pathological process, think Differential Diagnosis!
**Prepare for transvenous pacing (TVP), managed by an expert, if TCP fails. |
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