✅
Confirm ROSC?
Return of spontaneous circulation — this will stop all timers
🫁
Confirm Airway Change
Switching airway device — confirm placement and ventilation
🛑
Terminate Code?
All resuscitation efforts to be ceased — this will stop all timers
30 Minutes Elapsed
Resuscitation has been ongoing for 30 minutes. Do you wish to continue or consider termination?
↺
End Code Blue?
Select outcome or cancel to continue
📄
Export Before Reset?
Would you like to save the event log and summary as a PDF before clearing?
🫀
ROSC Achieved
Would you like to proceed to the post-ROSC checklist?
Bradyarrhythmia Algorithm
Step
1 of 3
Identify & Treat Underlying Cause · AHA 2020
Initial Assessment — ABCDE
A: Airway patent?
B: Assess breathing — Rate, Depth, Pattern, SpO₂
C: Cardiac monitor — HR, Rhythm, BP, ECG
D: Drugs — Obtain IV access
E: 12-lead ECG — don't delay treatment
Consider Underlying Causes
Myocardial ischaemia / infarction
Drugs / toxicologic — CCB, beta-blockers, digoxin
Hypoxia
Electrolyte abnormality — e.g. hyperkalaemia
Bradyarrhythmia Algorithm
Step
2 of 3
Persistent Bradyarrhythmia · AHA 2020
Is the persistent bradyarrhythmia causing any of the following?
Hypotension
Acutely altered mental status
Signs of shock
Ischaemic chest discomfort
Acute heart failure
👁
Monitor and Observe
No adverse signs — continue monitoring.
Reassess if clinical status changes.
Bradyarrhythmia Algorithm
Step
3 of 3
Treatment — Symptomatic Bradycardia · AHA 2020
First Line
Atropine IV
First dose 1 mg IV bolus
Repeat Every 3–5 minutes
Maximum 3 mg total
If Atropine Ineffective
Transcutaneous Pacing
Preferred if atropine fails — initiate without delay
and / or
Dopamine IV infusion
5–20 mcg/kg/min · titrate to response · taper slowly
or
Epinephrine IV infusion
2–10 mcg/min · titrate to response
Consider
Expert consultation · Transvenous pacing
Tachyarrhythmia Algorithm
AHA ACLS 2020 Guideline Based
Assess for tachyarrhythmia:
Heart rate typically ≥150 / min
Clinically appropriate for patient's condition
Does this patient meet criteria for tachyarrhythmia?
Tachyarrhythmia Algorithm
Step
1 of 4
Identify & Treat Underlying Cause · AHA 2020
Initial Assessment — ABCDE
A: Airway patent?
B: Assess breathing — Rate, Depth, Pattern, SpO₂
C: Cardiac monitor — HR, Rhythm, BP, ECG
D: Drugs — Obtain IV access
E: 12-lead ECG — don't delay treatment
Tachyarrhythmia Algorithm
Step
2 of 4
Persistent Tachyarrhythmia · AHA 2020
Is the persistent tachyarrhythmia causing any of the following?
Hypotension
Acutely altered mental status
Signs of shock
Ischaemic chest discomfort
Acute heart failure
Tachyarrhythmia Algorithm
Step
3 of 4 Unstable
Synchronized Cardioversion · AHA 2020
Synchronized Cardioversion
Don't forget to synchronise the defibrillator
Sedation — consider before cardioversion
Consent to be taken if patient conscious
Crash cart to be ready
Energy — use device manufacturer's recommended level
Narrow Regular Rhythm — Consider Adenosine
FIRST DOSE
6 mg IV push
Rapid · follow with NS flush
SECOND DOSE
12 mg IV push
If 1st dose ineffective · NS flush
Tachyarrhythmia Algorithm
Step
4 of 4Unstable
If Refractory · Antiarrhythmic Infusions · AHA 2020
If Refractory — Consider
Search for and treat underlying cause
Increase energy level for next cardioversion
Add antiarrhythmic drug
Expert consultation
Antiarrhythmic Infusions
Procainamide IV
20–50 mg/min until arrhythmia suppressed, hypotension, QRS widens >50%, or max 17 mg/kg given
Maintenance: 1–4 mg/min
Caution: Avoid if prolonged QT or CHF
Amiodarone IV
150 mg over 10 minutes — repeat if VT recurs
Maintenance: 1 mg/min for first 6 hours
Sotalol IV
100 mg (1.5 mg/kg) over 5 minutes
Caution: Avoid if prolonged QT
Adenosine IV
Narrow regular tachycardia · AHA 2020
FIRST DOSE
6 mg rapid IV push
Follow immediately with NS flush
SECOND DOSE
12 mg rapid IV push
If first dose ineffective · follow with NS flush
Refractory Tachyarrhythmia
If cardioversion unsuccessful · AHA 2020
Search for and treat underlying cause
Increase energy level for next cardioversion
Add antiarrhythmic drug
Expert consultation
Antiarrhythmic Infusions
Unstable · Wide QRS
Stable Wide-QRS Tachycardia · AHA 2020
Procainamide IV
Loading 20–50 mg/min until arrhythmia suppressed, hypotension, QRS widens >50%, or max 17 mg/kg given
Maintenance 1–4 mg/min
Avoid if Prolonged QT or CHF
Amiodarone IV
First dose 150 mg over 10 minutes — repeat if VT recurs
Maintenance 1 mg/min for first 6 hours
Sotalol IV
Dose 100 mg (1.5 mg/kg) over 5 minutes
Avoid if Prolonged QT
Tachyarrhythmia Algorithm
Step
3 of 4Stable
QRS Assessment · AHA 2020
Is the QRS wide?
QRS ≥ 0.12 seconds
≥ 3 small squares on ECG
Stable Wide QRS Tachycardia
Step
4 of 4
AHA 2020
If Regular and Monomorphic — Consider
Adenosine — only if regular and monomorphic
Antiarrhythmic infusion
Expert consultation
Adenosine IV doses
FIRST DOSE
6 mg IV push
Rapid · NS flush
SECOND DOSE
12 mg IV push
If 1st dose ineffective · NS flush
Antiarrhythmic Infusions
Procainamide IV
20–50 mg/min until arrhythmia suppressed, hypotension, QRS widens >50%, or max 17 mg/kg given
Maintenance: 1–4 mg/min
Caution: Avoid if prolonged QT or CHF
Amiodarone IV
150 mg over 10 minutes — repeat if VT recurs
Maintenance: 1 mg/min for first 6 hours
Sotalol IV
100 mg (1.5 mg/kg) over 5 minutes
Caution: Avoid if prolonged QT
Stable Narrow QRS Tachycardia
Step
4 of 4
AHA 2020
Management
Vagal manoeuvres — if regular
Adenosine — if regular
Beta-blocker or calcium channel blocker
Consider expert consultation
Adenosine IV doses
FIRST DOSE
6 mg IV push
Rapid · NS flush
SECOND DOSE
12 mg IV push
If 1st dose ineffective · NS flush
Infusion Rate Calculator
5 20
Infusion Rate
— ml/hr
Bradyarrhythmia Algorithm
AHA ACLS 2020 Guideline Based
Assess for bradyarrhythmia:
Heart rate typically <50 / min
Clinically appropriate for patient's condition
Does this patient meet criteria for bradyarrhythmia?
⚠️ CPR Stopped
0
seconds without compressions
⚡ Resume CPR as soon as possible
💜
Confirm Amiodarone
300 mg IV — 1st dose
⏰ Amiodarone
Time for 2nd Dose?
150 mg IV — 2nd dose
⚡ VF
Shockable Rhythm Detected
⏸
Stop CPR — Assess Now
Pulse · Respiration · Rhythm
10 / 10 sec
🫁 Breathing? 🫀 Carotid/Femoral pulse? 📈 Rhythm?
📈 Select Rhythm
🫀 Pulse Present?
🫀
Start CPR
Rate 100–120 / min
Depth 5–6 cm
Ratio 30 : 2
Initial Rhythm?

Select the presenting rhythm to begin ACLS protocol

VF
Ventricular FibrillationShockable
pVT
Pulseless Ventricular TachycardiaShockable
Asystole
No Electrical ActivityNon-shock
PEA
PEA: No PulseNon-shock
Rhythm Check in 15s
Prepare before CPR ends
⚡ Charge the defibrillator and be ready
👤 Next compressor — get ready to rotate
🫀 Feel the femoral pulse
⚠️
Non-Shockable Rhythm!
Current rhythm is non-shockable (PEA / Asystole). Defibrillation is NOT indicated. Are you sure you want to deliver a shock?
⚡
Confirm Shock Delivered?
Energy: —
⚡
Shock Delivered
Resume CPR immediately — do not check pulse
💊
3rd Shock Delivered
Consider antiarrhythmic — Amiodarone 300 mg or Lignocaine 1–1.5 mg/kg IV
💉
Epinephrine Advised
1 mg IV/IO as soon as access available — first dose not yet given
⚠️
Too Soon?
Only 0:00 since last dose — minimum interval is 3–5 min. Give anyway?
💉
Confirm Epinephrine
1 mg IV/IO — administer now?
🫁
Airway Check
5 minutes elapsed — confirm current airway device
Current airway
⏱
Time of Airway Change
When was this device placed?
Select time
🧪
ABG / VBG
Has a blood gas been obtained? — 8:00 elapsed
Reversible Cause
Treatment Options
Stop CPR
Select reason for stopping
Confirm?
Reset Epi Timer?
This will reset the epinephrine countdown timer.
Post-ROSC Checklist
Phase 1 of 3
Initial Stabilisation · AHA 2020
Airway
Endotracheal intubation done
Waveform capnography to confirm ETT
Respiration
Rate 10 breaths/min — titrate to achieve target PaCO₂
SpO₂ 92–98% achieved
PaCO₂ 35–45 mmHg targeted
Haemodynamics
SBP >90 mmHg
MAP >65 mmHg
IV Fluid bolus (1 - 2 L)
Inotrope / vasopressor given
⚠️
Items Not Yet Done
The following Phase 1 items are still marked No. Proceed anyway?
Post-ROSC Checklist
Phase 2 of 3
Continued Management · AHA 2020
Cardiovascular Status
12-lead ECG obtained
STEMI present?
Unstable cardiogenic shock present?
Post-ROSC Checklist
Phase 3 of 3
Continued Management — Comatose · AHA 2020
Targeted Temperature Management (TTM)
Start TTM as soon as possible · 32–36°C for 24 hours using a cooling device with feedback loop
Neuroimaging
Obtain brain CT
EEG Monitoring
Continuous or intermittent EEG monitoring
Other Critical Care Management
Ensure the following:
Continuously monitor core temperature (oesophageal, rectal, bladder)
Maintain normoxia, normocapnia, euglycaemia
Continuous or intermittent EEG monitoring
Lung-protective ventilation
Post-ROSC Checklist
Phase 3 of 3
Continued Management — Patient Awake · AHA 2020
Critical Care Management
Ensure the following:
Continuously monitor core temperature (oesophageal, rectal, bladder)
Maintain normoxia, normocapnia, euglycaemia
Continuous or intermittent EEG monitoring
Lung-protective ventilation
🧠
Following Commands?
Is the patient following commands after ROSC?
Cardiac Intervention
Emergent Cardiac Intervention
Consider the following:
Emergent cardiac catheterisation
Mechanical circulatory support
⚠️
Skip Post-ROSC Checklist?
The post-ROSC checklist helps ensure critical steps are not missed. Are you sure you want to skip?
⚠️
Close Checklist?
All checklist data entered will be lost. Are you sure you want to close?
Reversible Causes
10:00 elapsed — have you considered and addressed all 5H5T causes?
⚠️
Not Yet Advised
Amiodarone / Lignocaine is recommended only after the 3rd shock as per AHA guidelines. Only 0 shock(s) given so far. Do you still want to administer?
💊
Confirm Drug
—
Other Medications

Tap to mark administration — enter dose before confirming

🟡 Magnesium Sulphate
Torsades de pointes · 2 g IV over 10 min
g
🟠 Atropine
Symptomatic bradycardia · 0.5–1 mg IV
mg
⚗️ Sodium Bicarbonate (NaHCO₃)
Acidosis / hyperkalaemia · 50 mEq IV
mEq
🔴 Adrenaline Infusion
Post-ROSC · 0.01–1 mcg/kg/min · titrate to MAP >65 mmHg
mcg/min
🔴 Noradrenaline Infusion
Post-ROSC · 0.01–3 mcg/kg/min · vasopressor of choice
mcg/min
📝 Any Other Medicine
Enter drug name and dose — logged to event timeline
🩺 Procedures Log
Tap to log — adds timestamp to event timeline
Vascular Access
Airway Procedures
Chest Procedures
Monitoring & Diagnostics
Other Procedure
Confirm Procedure
—
⏱ Code Blue Timer
00:00
● Stopped Start: —
🫀 CPR Cycle
00:00
Cycle 1
Start code first
💉 Epinephrine
⚠ Epi Due!
00:00
Dose 0
Start code first
⚡ Shock Delivery
Shocks
0
Energy
—

Biphasic: 120–200 J · Monophasic: 360 J · Resume CPR immediately after shock.

💊 Medications
💜 Amiodarone 0
💙 Lignocaine 0
🧪 Other Medications MgSO₄ · Atropine · NaHCO₃
🫁 AIRWAY AND PROCEDURES
🫁 Present airway device: Bag Mask Ventilation
🩺 Procedures
ALGORITHMS
📈 Cardiac Arrest Rhythms
⚡ Shockable
Ventricular Fibrillation
Pulseless VT
🚫 Non-Shockable
PEA: No Pulse
Asystole
🔍 Reversible Causes – 5H5T · tap a cause to see treatments
5 H's
Hypoxia
›
Hypovolaemia
›
Hypo/HyperK
›
Hypothermia
›
H⁺ Acidosis
›
5 T's
Tension PTX
›
Tamponade
›
Toxins
›
PE
›
Coronary (MI)
›
✅ ROSC Achieved
ROSC Time—
Code Duration—

✓ 12-lead ECG  |  ✓ SpO₂ 94–98%
✓ Avoid hypotension (SBP ≥90 mmHg)
✓ Targeted temperature management
✓ Consider PCI / treat underlying cause

📊 Summary & Outcome
📊 Resuscitation Summary
OutcomeIn progress
0
CPR Cycles
0
Shocks
0
Epinephrine
0
Antiarrhythmics
0
0
Started—
Duration—
📋 Event Log
Time Code+ Event · Details
Start Code Blue to begin logging
📝 Notes
🫀
Torsades de Pointes?
2nd antiarrhythmic given + shockable rhythm — consider Torsades de Pointes
Torsades de Pointes — polymorphic VT with QT prolongation. Treatment: MgSO₄ 2 g IV over 5–10 min.
🫁
Advanced Airway In Place
🫀
Compressions
100–120 / min — continuous, uninterrupted
🫁
Ventilation
10 breaths / min — 1 breath every 6 seconds
🚫
30:2 ratio not required
Do not pause compressions to ventilate
⚠️
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