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414
80 .

415
416
417
81 .

418
419
82 .

420
421
421
423
424
425
426
427
83 -

428
429
430
431
432
433
84 .

KARTHIK's

An!"!ia not!

434
435
KARTHIK's

An!"!ia not!

436
437
438
439
KARTHIK's

An!"!ia not!

440
KARTHIK's

An!"!ia not!

441
85 .

442
443
444
445
VF / p VT

§ SHOCK

CPR 2mm
IVI IO access

I
tidy thin shockable ? [YES]
G.
L SHOCK
CPR 2 main

Epinephrine every 3 5
-
Min

consider advanced aw way ,

cap no
graphs
I
Rylhm Shockable ? [YES]

{ L SHOCK
CPR 2 ME n
'

Ami o damone / Lidocaine


-

Treat reversible causes

446
Shock Energy for Defibrillation :

→ BE phasic :

instead dose of
Manufacturer recommendation Ceg ,

if unknown maximum available


120 j) use .

- 200 ; ,

Second & subsequent doses should be equivalent ,

doses be considered
and higher may

→ Mono phasic : 360 J

2020 )
[ T AHA cardiac Arrest recommendations

→ continued

447
VF / p VT

§ SHOCK

CPR 2mm
IVI IO access

to
tidy thin shockable ? [YES]
G.
L SHOCK
CPR 2 main

Epinephrine every 3 5
-
min

consider advanced aw way ,

I
Rylhm shockable ? [YES]

{ L SHOCK
CPR 2 ME n
'

Ami o danone / Lidocaine


-

Treat reversible causes

448
Shock Energy for Defibrillation ( Pediatric )

* First shock : 231 Kg

* second shock :
431kg
*
Subsequent Shocks : >
471kg
Maximum : 10J
1kg or adult dose

For synchronized cardio version

( for pulse 1 unstable )


pediatric VT + SVT

worth
* Began 0.5 -
I 31kg ;

Increase to 231kg
Tf not effective
.

Sedate If needed ,

but don't delay cardioversion .

444499
450
hhhhhhkhhhmhkht
SHOCK

ATRIAL FIBRILLATION
[CARDIOVERSION) Nµ9FFIm

rtwwhrrnhshrmnrhhhh
*
""

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EEE
.fi#h-ronpefebrsiIoaat;on
'

HOW TO USE

AN AED :
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,

451
86 .

452
453
454
455
456
87 -

457
458
459
460
461
462
463
464
465

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