BLS Healthcare Provider Adult Cardiac Arrest Algorithm—2015 Update

This flowchart depicts the BLS Healthcare Provider Cardiac Arrest Algorithm, which was updated in 2015. It shows the sequence of BLS skills to be performed when an adult is in cardiac arrest. A green box at the top contains text that states, “Verify scene safety.” This points downward to an orange box that says, “Victim is unresponsive. Shout for nearby help. Activate emergency response system via mobile device (if appropriate). Get A.E.D. and emergency equipment (or send someone to do so). From here, an arrow points downward to a red hexagon that instructs, “Look for no breathing or only gasping and check pulse (simultaneously). Is pulse definitely felt within 10 seconds?” From here, the chart takes three possible paths. If the patient is breathing normally and has a pulse, an arrow points to the left to a green box that directs, “Monitor until emergency responders arrive.” If the patient is not breathing normally but has a pulse, an arrow points to a green box to the right. It states: “Provide rescue breathing: 1 breath every 5 to 6 seconds, or about 10 to 12 breaths per minute. Activate emergency response system (if not already done) after 2 minutes. Continue rescue breathing; check pulse about every 2 minutes. If no pulse, begin CPR (go to CPR box [which is discussed next in this chart]). If possible opioid overdose, administer naloxone if available per protocol. The third path directs that if the patient is not breathing or only gasping and has no pulse, follow the arrow downward to the blue CPR box. Note that just above the CPR box, there is a dashed, horizontal line with text that says, “By this time in all scenarios, the emergency response system or backup is activated, and A.E.D. and emergency equipment are retrieved or someone is retrieving them.” The CPR box instructs, “Begin cycles of 30 compressions and 2 breaths. Use A.E.D. as soon as it is available.” An arrow points downward to a white box that says, “A.E.D. arrives.” From there, an arrow points downward to a red hexagon that says, “Check rhythm. Is it a shockable rhythm?” From here, there are two possible pathways. If the answer is “Yes, it’s a shockable rhythm,” an arrow points to a blue box that instructs, “Give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by AED to allow rhythm check). Continue until A.L.S. providers take over or victim starts to move.” If the answer is “No, it’s a non-shockable rhythm,” an arrow guides to another blue box that advises, “Resume CPR immediately for about 2 minutes (until prompted by A.E.D. to allow rhythm check). Continue until A.L.S. providers take over or victim starts to move.” These boxes both cycle back to the red hexagon that says, “Check rhythm. Is it a shockable rhythm?” repeating these final steps. This figure is copyright 2015 by the American Heart Association.