The Asystole ACLS Algorithm and How it Can Help Save Lives

Learn the ACLS algorithm for treating asystole with Medical ProCerts online certification course.

What is Asystole and What is the ACLS Algorithm for Treatment?

Asystole is a dangerous arrhythmia in which the heart stops beating–commonly known as “flatline”. It is often a cause of cardiac arrest, and can be fatal if not treated quickly. The American Heart Association (AHA) has updated their Advanced Cardiovascular Life Support (ACLS) guidelines for the management of asystole in 2020. Here, we will discuss the asystole ACLS algorithm according to the AHA’s 2020 guidelines.

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How to Recognize Asystole and Initiate Treatment According to the ACLS Algorithm

The asystole ACLS algorithm consists of a series of steps that healthcare providers should follow when managing a patient in cardiac arrest due to asystole. The first step is to confirm asystole through the use of an electrocardiogram (ECG). Once asystole has been confirmed, healthcare providers should perform high-quality cardiopulmonary resuscitation (CPR) immediately, starting with chest compressions.

Asystole rhythm as visualized on an ECG.

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Overview of the Basic Steps in the Asystole ACLS Algorithm

The AHA recommends a compression rate of at least 100-120 per minute and a compression depth of at least 2 inches (5 cm) for adults. Providers should also deliver oxygen and provide ventilation at a rate of 10 breaths per minute, ensuring adequate chest rise and fall.

Next, healthcare providers should check for a reversible cause of asystole, such as hypovolemia, hypoxia, acidosis, hyperkalemia, hypothermia, or tamponade (the H’s and T’s). If a reversible cause is identified, appropriate treatment should be initiated immediately.

If there is no reversible cause identified, the AHA recommends the administration of epinephrine 1 mg every 3-5 minutes during resuscitation. Additionally, healthcare providers may consider advanced airway management, such as endotracheal intubation, if indicated.

The asystole ACLS algorithm also emphasizes the importance of regular reassessment during resuscitation efforts. If no return of spontaneous circulation is achieved, the healthcare team should consider stopping resuscitation efforts after approximately 20 minutes or if signs of irreversible death are present.

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The Asystolic ACLS AHA Algorithm Updates from 2020

The asystole ACLS algorithm according to the AHA’s 2020 guidelines emphasizes the importance of high-quality CPR, identification and treatment of reversible causes, and the use of epinephrine to help improve the chances of survival for patients in cardiac arrest due to asystole. Healthcare providers should review the guidelines regularly to ensure that they are providing the best possible care to their patients.

RELATED: Download an ACLS Algorithm Pack

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Where to Learn More About ACLS Algorithms

Training in Advanced Cardiac Life Support (ACLS) includes valuable information such as algorithms, mnemonics, drug dosage charts, updated guidelines recommended by the AHA, and learning tools to help you upgrade your skills as an advanced cardiac life support provider.

Medical Pro Certs offers ACLS certification that is 100% online, accredited, and easy to complete in under 3 hours! Get certified AND get 3CME credits INSTANTLY with Medical ProCerts today.

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