Emt Mlrems 3.0: Adult Cardiac Life Support

Front 1

3.0 Cardiac Arrest- General Procedures (Protocol)

Back 1

1. Verify patient is pulseless and apneic.
2. Initiate or continue CPR. CPR is to be continued at all times as is practical.
3. Assure airway patency and begin use of BVM. Provide initial BLS airway management, including Oropharyngeal or
Nasopharyngeal Airway.
4. Apply AED or SAED if available. If switching to a different AED/monitor you may use previously applied patches if
compatible with new unit.
5. Follow prompts provided by AED/SAED device.
6. Utilize ALS, or initiate timely transport toward ALS (ALS intercept or hospital if closer). If ALS not available and
transport ambulance is available, no more than 3 shocks should be delivered at the scene. Defibrillation should not
be performed in a moving ambulance.
7. Advise receiving hospital ASAP.

Front 2

3.2 Return of Spontaneous Circulation (Criteria and Protocol)

Back 2

CRITERIA
• The following is for a patient with Return of Spontaneous Circulation (ROSC) as evidenced by a palpable pulse
following CPR, electrical, or drug therapy for a patient previously pulseless.
• Post-conversion treatment of VF or VT should only be started if the patient has regained a pulse of adequate
rate (>60). If not, refer to other cardiac protocols as appropriate.
1. Routine medical care.

Front 3

3.4 Bradycardia (Criteria and Protocol)

Back 3

CRITERIA
• Bradycardia may be absolute (HR <60 bpm) or relative, which is a rate slower than expected for the patient’s
condition. Bradycardia may be normal status for patient on beta blockers or with an athletic life style.
• Treatment listed to be used only if one or more of these conditions exist:
• altered mental status
• severe chest pain
• lightheadedness, dizziness, nausea
• systolic BP <90 mmHg, or relative hypotension for patient
• frequent PVCs
1. Routine medical care

Front 4

3.5 Unstable Tachycardia (Criteria and Protocol)

Back 4

CRITERIA
• Stable Tachycardia - Asymptomatic or minor symptoms (palpitations, heart racing, etc.)
• Unstable Tachycardia - HR > 150 bpm with mental status change or evidence of shock (hypotension, poor
peripheral pulses, cool distal extremities)
1. Routine medical care.

Front 5

3.6 Stable Narrow Complex Tachycardia (Criteria and Protocol)

Back 5

CRITERIA
• Supraventricular is defined as non-sinus, narrow complex tachycardia with HR usually > 150 bpm.
• If ECG complex > 0.12 seconds, refer to Wide Complex Tachycardia Protocol (3.7), especially if patient > 50
years of age, or has a history of previous MI, coronary artery disease, or CHF.
• Stable Narrow Complex Tachycardia protocol - asymptomatic or minor symptoms (palpitations, heart racing, etc.)
• Unstable Narrow Complex Tachycardia protocol - HR >150 bpm with mental status change or evidence of
shock (hypotension, poor peripheral pulses, cool distal extremities)
1. Routine medical care.

Front 6

3.7 Stable Wide Complex Tachycardia (Criteria and Protocol)

Back 6

CRITERIA
• If patient has wide complex tachycardia and is pulseless, refer to VF/ Pulseless VT Protocol (3.1)
• Stable VT protocol - Asymptomatic or minor symptoms (palpitations, heart racing, etc.)
• Unstable VT protocol – HR >150 bpm with altered mental status changes or evidence of shock (hypotension,
poor peripheral pulses, cool distal extremities).
1. Routine medical care.