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Important 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 J).
• 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
• 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.