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Asystole is treated by cardiopulmonary resuscitation (CPR) combined with an intravenous vasopressor such as epinephrine (a.k.a. adrenaline). Sometimes an underlying reversible cause can be detected and treated (the so-called "Hs and Ts", an example of which is hypokalaemia).
What is the treatment for asystole?
For most patients, true asystole is the result of a prolonged illness or cardiac arrest, and prognosis is very poor. The few patients that have a positive outcome following a diagnosis of cardiac arrest with asystole will usually result from the identification and correction of an underlying cause of the asystole.
What is the prognosis of asystole?
When treating asystole, epinephrine can be given as soon as possible but its administration should not delay initiation or continuation of CPR. After the initial dose, epinephrine is given every 3-5 minutes. Rhythm checks should be performed after 2 minutes (5 cycles) of CPR.
When should epinephrine be given to a patient with asystole?
Some theoretically reversible causes of asystole include: 1 Cardiac Tamponade 2 Coronary and Pulmonary Thrombosis 3 Hypovolemia 4 Hypoxemia 5 Hydrogen ion (acidosis) 6 Hyperkalemia 7 Hypokalemia 8 Hypothermia 9 Toxins 10 Tension pneumothorax More ...
What are the possible causes of asystole?
What happens when a patient is in asystole?
Asystole (ay-sis-stuh-lee) is when there's no electricity or movement in your heart. That means you don't have a heartbeat. It's also known as flatline. That's because doctors check the rhythm of your heart with a machine called an electrocardiogram -- also called an ECG or EKG.
What drug do you give first for asystole?
Standard drug therapy for asystole during cardiac arrest includes epinephrine, atropine, and calcium chloride (CaCl). Recent studies have shown that ventricular fibrillation (VF) can appear to be asystole when recorded from the chest surface.
Should you use an AED for asystole?
Children or adults who develop cardiac arrest caused by a slowing of the heart rate (bradycardia) or cardiac standstill (asystole) cannot be treated with an AED. These rhythms do not respond to electric shocks, so the AED will not allow a shock to be activated and standard CPR measures should be performed.
Which are the most appropriate drugs to treat asystole or pulseless electrical activity?
Atropine is inexpensive, easy to administer, and has few side effects and therefore can be considered for asystole or PEA. The recommended dose of atropine for cardiac arrest is 1 mg IV, which can be repeated every 3 to 5 minutes (maximum total of 3 doses or 3 mg) if asystole persists (Class Indeterminate).
What is asystole protocol?
Perform the initial assessment. Perform high-quality CPR. Establish an airway and provide oxygen to keep oxygen saturation > 94% Monitor the victim's heart rhythm and blood pressure.
Do you give adrenaline in asystole?
If asystole or PEA is identified give adrenaline (epinephrine) 10 micrograms per kilogram intravenously or intraosseously. Adrenaline (epinephrine) is the first line drug for asystole.
How is asystole treated?
When treating asystole, epinephrine can be given as soon as possible but its administration should not delay initiation or continuation of CPR. After the initial dose, epinephrine is given every 3-5 minutes. Rhythm checks should be performed after 2 minutes (5 cycles) of CPR.
When is the recommended point to administer epinephrine to a patient with asystole?
Administer first dose of epinephrine after the second defibrillation.
What happens if you defibrillate asystole?
If it is fine v-fib, you may terminate the rhythm; however, if the rhythm is asystole, defibrillation will be ineffective and you can follow the asystole protocol with confidence.
What are the initial steps of treating asystole PEA?
1. Initial treatment of asystole/PEA is as follows: Continue CPR for 2 minutes....Check pulse and rhythm every 2 minutes, as follows:If nonshockable, see Nonshockable Rhythm (above).If shockable, see Shockable Rhythm (above).Rotate chest compressors.Identify and treat reversible causes.
Is vasopressin given for asystole?
In addition, both vasopressin and epinephrine were included among prompt resuscitative measures recommended for the treatment of ventricular asystole.
Do you give amiodarone for asystole?
Amiodarone serum level was within therapeutic range. The possible electrophysiologic mechanisms by which amiodarone might suppress both normal and abnormal pacemakers are discussed. The occurrence of asystole at therapeutic serum concentration of amiodarone suggests that this drug should be used with caution.
What is the best medicine for asystole?
For asystole, the standard medication to use is epinephrine.
What is an asystole?
Asystole, otherwise known as a flatline, is a state of cardiac standstill in which all electrical activity has ceased.
How often should you do a rhythm check for CPR?
Following the initial dose, epinephrine is given every 3-5 minutes as needed. During CPR, a rhythm check should be done every 2 minutes (5 cycles). These rhythm checks should be kept to less than 10 seconds, in order to prevent meaningful interruptions in CPR.
What to do if your rhythm is incorrect?
If you believe the rhythm may be incorrect, ensure patches have good contact with the individual, leads are connected, the gain is set appropriately, and the power is on. If all equipment appears to be functioning normally, and you still see a rhythm that appears to be asystole, quick action is imperative.
Is defibrillation effective for asystole?
Because asystole is not a shockable rhythm, defibrillation is not an effective asystole treatment. Researchers estimate that less than two percent of people who suffer asystole outside of the hospital will survive - even with trained emergency intervention.
Is asystole a flatline?
Identifying Asystole. Confirmation that the rhythm is indeed a flatline, and not a false positive, is an important part of the asystole treatment algorithm. For most patients, true asystole is the result of a prolonged illness or cardiac arrest, and prognosis is very poor.