V-Fib or Pulseless V-Tach

■ Shock: (biphasic: 200 J; monophasic: 360 J) reassess rhythm.

■ CPR: Immediately perform 5 cycles of CPR (about 2 min).

■ Epinephrine 1 mg IV or IO (2–2.5 mg ET) every 3–5 min or Vasopressin 40 units IV or IO, one time only. May use to replace 1st or 2nd dose of epinephrine (given without interrupting CPR).

■ Shock: (biphasic: 200 J; monophasic: 360 J) reassess rhythm.

■ Consider antiarrhythmics (given without interrupting CPR):

■ Amiodarone 300 mg IV or IO, may repeat 150 mg in 3–5 min.

■ Lidocaine 1.0–1.5 mg/kg IV or IO, may repeat 0.5–0.75 mg/kg q5–10 min, max 3 mg/kg.

■ Magnesium 1–2 g IV or IO for Torsade de Pointes.