Changes in the CPR-Pharmacological Guidelines 2000
An intravenous bolus of amiodarone 300 mg should be
considered when the patient has ventricular fibrillation or when pulseless
ventricular tachycardia does not respond to three shocks (2300 J, 200 J, 360
Atropine 3 mg is now indicated for pulseless electrical
activity (electromechanical dissociation) with a ventricular rate of less than
60 a minute, as well as for asystole.
The international guidelines recommend a single intravenous
dose of 40 units of vasopressin as an alternative to adrenaline in cases of
ventricular fibrillation or pulseless ventricular tachycardia refractory to
three initial shocks.
The European Resuscitation Council and the Resuscitation
Council (UK) continue to recommend epinephrine (adrenaline) 1 mg every three
minutes during cardiopulmonary resuscitation.
A recent study of cardiac arrests occurring in hospital
failed to detect any advantage for survival of vasopressin over epinephrine.
The administration of "high dose epinephrine (5 mg)
and bretylium is no longer recommended.