Advanced Life Support Guidelines

Guideline Code

RECOVER Code(s)

Issue

Guideline

Class
(Def)

Level
(Def)

Comments

G-ALS-01

ALS01

Epinephrine

The use of low dose (0.01 mg/kg) epinephrine administered every 3-5 minutes early in CPR is recommended.

I

B

Click

G-ALS-02 ALS01   The use of high dose (0.1 mg/kg) epinephrine may be considered after prolonged CPR. IIb B Click
G-ALS-03 ALS02 Atropine In dogs and cats with asystole or PEA potentially associated with increased vagal tone, use of atropine is reasonable. IIa B Click
G-ALS-04 ALS02   In dogs and cats routine use of atropine during CPR may be considered. IIb C Click
G-ALS-05 ALS03 Vasopressin The use of vasopressin (0.8 U/kg) as a substitute or in combination with epinephrine every 3-5 minutes may be considered. IIb B Click
G-ALS-06 ALS05 Defibrillation The use of a biphasic defibrillator is recommended over a monophasic defibrillator. I A Click
G-ALS-07 ALS05   External defibrillation dosing should start at 4-6 J/kg with a monophasic defibrillator and 2-4 J/kg with a biphasic defibrillator. IIa B Click
G-ALS-08 ALS05   Administration of a single shock as opposed to 3 stacked shocks is recommended, with immediate resumption of CPR in the case of non-successful defibrillation. I B Click
G-ALS-09 ALS07   Defibrillation for treatment of non-perfusing VF/VT is recommended over routine use of anti-arrhythmic drugs. I B Click
G-ALS-10 ALS08   Immediate defibrillation is recommended in cases of CPA due to VF of duration of 4 minutes or less. I B Click
G-ALS-11 ALS08   Immediate defibrillation may be considered if VF is diagnosed during a rhythm check between cycles of CPR. IIb B Click
G-ALS-12 ALS08   A 2 minute cycle of CPR should precede defibrillation in cases of CPA due to VF of known or suspected duration of greater than 4 minutes. I B Click
G-ALS-13 ALS15   In dogs and cats with VF, defibrillation energy escalation is reasonable if the first countershock is unsuccessful. IIa B Click
G-ALS-14 ALS07 Amiodarone Amiodarone may be considered in cases of pulseless VT/VF resistant to defibrillation. IIb B Click
G-ALS-15 ALS07   When amiodarone is not available, lidocaine may be considered in cases of pulseless VT/VF resistant to defibrillation. IIb B Click
G-ALS-16 ALS07 Magnesium Routine use of MgSO4 is not recommended for cardiac arrythmias, but may be considered for treatment of torsades de pointes. IIb B Click
G-ALS-17 ALS10 Impedance Threshold Device Use of an Impedance Threshold Device (ITD) to enhance circulation is reasonable in animals > 10kg. IIa B Click
G-ALS-18 ALS11 Corticosteroids The routine use of corticosteroids during CPR is not recommended. III C Click
G-ALS-19 ALS13 Reversal Agents In dogs and cats that have received reversible anesthetic/sedative
medication, administering reversal agents during CPR may be
considered.
IIb C Click
G-ALS-20 ALS13 Naloxone In cases of opioid toxicity, naloxone should be used during CPR. I B Click
G-ALS-21 ALS13   In cases of recent opioid administration, the use of naloxone during CPR may be considered. IIb B Click
G-ALS-22

ALS12
ALS14

Calcium The routine use of intravenous calcium in dogs and cats during CPR is not recommended. III B Click
G-ALS-23 ALS12
ALS14
 

Intravenous calcium may be considered in dogs and cats with documented moderate hypocalcemia during CPR.

IIb C Click
G-ALS-24 ALS12 Potassium Documented hyperkalemia should be treated during CPR. I B Click
G-ALS-25 ALS12   Treatment of documented hypokalemia during CPR may be considered. IIb C Click
G-ALS-26 ALS09 Intratracheal Administration In animals in which intravenous or intraosseous access is not possible, the use of the intratracheal route for epinephrine, vasopressin, or atropine may be considered. IIb B Click
G-ALS-27 ALS09   If the intratracheal route is used for drug administration during CPR, drugs should be diluted with saline and administered via a catheter longer than the endotracheal tube. I B Click
G-ALS-28

ALS-CPR-A-011A (ILCOR)

PA08

Supplemental Oxygen Administration During CPR in dogs and cats, the use of an FiO2 of 100% is reasonable. IIa B Click
G-ALS-29

ALS-CPR-A-011A (ILCOR)

PA08

  During CPR in dogs and cats, the use of an FiO2 of 21% (room air) may be considered. IIb B Click
G-ALS-30 ALS-D-016A(ILCOR) IV Fluid Administration During CPR in euvolemic or hypervolemic dogs and cats, routine administration of intravenous fluids is not recommended. III B Click
G-ALS-31 ALS-D-016A(ILCOR)   During CPR in dogs and cats with documented or suspected pre-existing hypovolemia, administration of intravenous fluids is reasonable. IIa C Click
G-ALS-32 PA18 Alkalinization Therapy Alkalinization therapy after prolonged CPA of greater than 10-15 minutes with administration of 1mEq/kg of sodium bicarbonate may be considered. IIb B Click