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ACLS Megacode 7 Out-of-Hospital

Hurry, don’t let time run out!

Vital signs

Physiological systems

TCP is not always available

Dopamine and epinephrine can be administered as alternatives when TCP is not available.

Dopamine and epinephrine can be administered as alternatives when TCP is not available.

TCP is prepared, but before an attempt to capture can be performed, the patient deteriorates, a drop in BP occurs, and they become unresponsive. A rhythm check reveals a conversion from a third-degree atrioventricular block to ventricular fibrillation. Respiratory support is provided via BVM.

Epinephrine is administered and the remaA single unsynchronized shock of 120 J is delivered, and CPR is started for five cycles. After five cycles of CPR, a rhythm check reveals unchanged ventricular fibrillation.

Transcutaneous pacing is attempted, and capture is successful. Strong peripheral pulses are noted bilaterally. HR 59/min, BP 91/70. Spontaneous respirations are noted, and the patient is transported to the hospital for post-cardiac arrest care.

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