<Diagram src="/figures/diagrams/als-algorithm.svg" alt="ALS algorithm flowchart" caption="ALS algorithm: shockable vs non-shockable rhythms" />
Shockable (VF/pVT)
Cycle
- Shock 200J biphasic
- CPR 2 minutes (30:2)
- Rhythm check
Drugs
- Adrenaline 1mg after 2nd shock, then every 2nd cycle
- Amiodarone 300mg after 3rd shock
Non-Shockable (Asystole/PEA)
Cycle
- CPR 2 minutes (30:2)
- Rhythm check
Drugs
- Adrenaline 1mg immediately, then every 2nd cycle
COACHED (Safe Defibrillation)
- Continue compressions
- Oxygen away (1m)
- All others away
- Charge defibrillator
- Hands off (announce clear)
- Evaluate rhythm
- Defibrillate or disarm
WARNING
Check for pacemaker - place pads 8cm away
Reversible Causes (4H 4T)
- Hypoxia, Hypovolaemia, Hypo/hyperkalaemia, Hypothermia
- Tension pneumothorax, Tamponade, Toxins, Thrombosis
Checklist Complete