You are called emergent to a 86 year old male patient who recently fell from standing. The patient is at a nursing home and staff state that they do not perform CPR at this facility due to liability. You find the patient unconscious, unresponsive, not breathing.
No matter the result of defibrillation, it is now the standard to “support” the heart by performing 2 more minutes of CPR and checking for pulse at next rhythm check.
With a BVM or other basic airway adjunct, the compression to ventilation ratio should be 30:2 for adult patients.
· Later on in the cardiac arrest, you have administered 1mg epinephrine 1:10, amiodarone 300mg, 1mg epinephrine 1:10, amiodarone 150mg, and the patient remains in V-Fib despite defibrillation every 2 minutes.
Treatment of reversible causes is always a factor, but in this case it is very important. Termination of resuscitation is not recommended unless patient converts to asystole, but will be based on local protocol.
