What are the 2015 AHA recommendations for the administration of drugs with cardiopulmonary resuscitation (CPR)?

Updated: Sep 15, 2020
  • Author: Catharine A Bon, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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Answer

Answer

The 2015 AHA guidelines offer the following recommendations for the administration of drugs during cardiac arrest [43] :

  • Amiodarone may be considered for or pVT that is unresponsive to CPR, defibrillation, and a vasopressor; lidocaine may be considered as an alternative (class IIb)

  • Routine use of magnesium for VF/pVT is not recommended in adult patients (class III)

  • Inadequate evidence exists to support routine use of lidocaine; however, the initiation or continuation of lidocaine may be considered immediately after ROSC from cardiac arrest due to VF/pVT (class IIb)

  • Inadequate evidence exists to support the routine use of a beta-blocker after cardiac arrest; however, the initiation or continuation of a beta-blocker may be considered after hospitalization from cardiac arrest due to VF/pVT (class IIb)

  • Atropine during pulseless electrical activity (PEA) or asystole is unlikely to have a therapeutic benefit (class IIb)

  • There is insufficient evidence for or against the routine initiation or continuation of other antiarrhythmic medications after ROSC from cardiac arrest

  • Standard-dose epinephrine (1 mg every 3-5 min) may be reasonable for patients in cardiac arrest (class IIb); high-dose epinephrine is not recommended for routine use in cardiac arrest (class III)

  • Vasopressin has been removed from the Adult Cardiac Arrest Algorithm and offers no advantage in combination with epinephrine or as a substitute for standard-dose epinephrine (class IIb)

  • It may be reasonable to administer epinephrine as soon as feasible after the onset of cardiac arrest due to an initial nonshockable rhythm (class IIb)


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