ACLS Medications Overview

Introduction

• Speaker: Marius from the Resuscitation Coach
• Channel Focus: All things resuscitation, including ACLS medications
• Audience: New ACLS students

Epinephrine (Adrenaline)

• Indications:
  • Cardiac arrest management
  • Symptomatic bradycardia
  • Hypotension post cardiac arrest
• Administration in Cardiac Arrest:
  • Dose: 1mg of 0.1 mg/ml (1:10,000 concentration)
  • Repeat every 3-5 minutes (every 4 minutes for efficiency)
  • Follow with a 20ml flush and elevate extremity
• Endotracheal Route:
  • Dose: 2-2.5 mg diluted in 10 ml normal saline
  • Less reliable uptake
• Bradycardia Infusion:
  • Start at 2-10 mcg/minute
  • Continuous infusion: 0.1-0.5 mcg/kg/minute

Amiodarone

• Common Names: Cordarone, Pacerone, "Big A"
• Indications:
  • Ventricular Fibrillation (VF)
  • Pulseless Ventricular Tachycardia (VT)
  • Stable wide QRS tachycardia
• Cardiac Arrest Administration:
  • First dose: 300 mg IV/IO push, followed by D5 water flush
  • Second dose: 150 mg IV/IO
• Pattern in VF/VT Arrest:
  • Alternate between Epinephrine and Amiodarone after defined shocks
  • Epinephrine after even number shocks (2,4,6)
  • Amiodarone after odd number shocks (3,5)
• Infusion:
  • Rapid: 150 mg IV over 10 minutes
  • Slow: 360 mg IV over 6 hours
  • Maintenance: 540 mg IV over 18 hours
  • Maximum dose: 2.2 grams over 24 hours

Adenosine

• Indications:
  • Stable narrow complex SVT
  • Unstable narrow complex reentry tachycardias
  • Regular, monomorphic wide complex tachycardia
• Administration:
  • Rapid push: 6 mg over 1-3 seconds
  • Second dose: 12 mg if needed
  • Short half-life (10 seconds)
  • Record rhythm strip before, during, and after
  • Explain effects to patient

Atropine

• Indications:
  • Symptomatic Sinus Bradycardia
  • AV nodal block (limited effectiveness)
• Administration:
  • Dose: 1 mg IV every 3-5 minutes
  • Maximum dose: 3 mg

Dopamine

• Indications:
  • Symptomatic bradycardia (second line after Atropine)
  • Hypotension management in shock
• Infusion Rate:
  • 5-20 mcg/kg/minute
  • Titrate against effect, taper slowly

Oxygen

• Use:
  • Maintain oxygen saturation 92-98%
  • Used when saturation ≤ 94%

Conclusion

• Encouragement to like, subscribe, and check out additional resources
• Importance of understanding ACLS medication protocols

This summary covers key medications used in ACLS protocols as discussed by Marius from the Resuscitation Coach. These notes focus on administration guidelines, indications, and practical tips for ACLS students.