Refractory VF / pVT

≥3 shocks without ROSC

First 30 seconds

  1. 1Optimise CPR quality (depth 5–6 cm, ≥100/min)
  2. 2Change defib pads (anterior–posterior)
  3. 3Amiodarone 300 mg after 3rd shock, 150 mg after 5th
A

Airway

  • • Patency, protect
  • • Adjuncts / definitive airway
B

Breathing

  • • RR, SpO₂
  • • O₂ to target sats
C

Circulation

  • • HR, BP, IV access
  • • Fluids/vasopressors
D

Disability

  • • AVPU/GCS, pupils, glucose
E

Exposure

  • • Full exposure, bleeding, source
View flowchart algorithm

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Clinical Decisions in Seconds