Regional Emergency Medical Advisory Committee of New York City
Prehospital Basic Life Support Protocols
Copyright January 1996 (8/96)

403 NON-TRAUMATIC CARDIAC ARREST

Begin Basic Cardiac Life Support procedures.

In witnessed arrests, administer a Precordial Thump.

Request Advanced Life Support assistance.

If appropriately trained personnel are present and a semi-automatic defibrillator is available, see below.

NOTE:DO NOT USE THE SEMI-AUTOMATIC DEFIBRILLATOR FOR PEDIATRIC PATIENTS LESS THAN 9 YEARS OF AGE.

Transport.

GUIDELINES FOR SEMI-AUTOMATIC DEFIBRILATION


NOTE:SEMI-AUTOMATIC DEFIBRILLATION SHOULD NOT BE DELAYED OR WITHHELD FOR ANY REASON IN PATIENTS 9 YEARS OF AGE OR OLDER WHO PRESENT WITH NON-TRAUMATIC CARDIAC ARREST.

If present, remove Nitroglycerin patch and wipe off remaining paste.

Avoid contacting the paste with your skin.

Attach semi-automatic defibrillator to patient.

NOTE:THE DEFIBRILLATOR'S ANALYSIS OF THE RHYTHM MUST BE DONE WITHOUT CPR IN PROGRESS AND MUST BE ACCOMPANIED BY A PULSE CHECK. IF THE PATIENT HAS A PERMANENT PACEMAKER IN PLACE, POSITION THE SEMI-AUTOMATIC DEFIBRILLATOR PADS AT LEAST 5 INCHES AWAY FROM THE PACEMAKER DEVICE.

Whenever the "NO SHOCK INDICATED" message appears, CPR should be performed for 1 MINUTE followed by a pulse check prior to the next analysis.

If the first analysis is "NO SHOCK INDICATED", re-analyze until a shock is indicated, or 6 "NO SHOCK INDICATED" messages appear.

Following 3 consecutive defibrillations without conversion, CPR should be performed for 1 MINUTE followed by a pulse check prior to the next analysis.

NOTE:UNDER NO CIRCUMSTANCES SHOULD A PATIENT WITH A PULSE BE DEFIBRILLATED, REGARDLESS OF THE DEFIBRILLATOR'S ANALYSIS.

After a patient has been defibrillated, if 2 consecutive "NO SHOCK INDICATED" messages appear, disconnect the machine, continue CPR, and transport.

NOTE:A MAXIMUM OF 6 DEFIBRILLATIONS MAY BE DELIVERED OR 6 "NO SHOCK INDICATED " MESSAGES RECEIVED PRIOR TO INITIATING TRANSPORT, UNLESS TRANSPORT IS DELAYED OR EXTENDED. IF TRANSPORT IS DELAYED OR EXTENDED, CONTINUE CPR, REANALYZE EVERY 1 MINUTE, AND SHOCK AS INDICATED UNTIL TRANSPORT IS EFFECTED.

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