Code Blue Alert
Bedside 402
Sudden Cardiac Arrest in Ward 4
A 58-year-old male post-CABG becomes unresponsive. Monitor shows erratic, disorganized waveforms without identifiable P-waves or QRS complexes. Patient is cyanotic.
ACLS Immediate Initial Action:
A. Check carotid pulse (5-10s), call Code Blue & request defibrillator / crash cart
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B. Order a stat 12-lead ECG and await cardiology consultation
C. Administer 100% O2 via nasal cannula and check fingerstick glucose first
Rhythm Analysis: Coarse Ventricular Fibrillation (VF)
SHOCKABLE
~^v~^~^v^^~^v~^~^v~^v~^ (Coarse VF 320 bpm)
Defibrillation Decision:
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Clear bed & deliver 200 Joules Biphasic Defibrillation shock immediately
ACLS CLASS I
Deliver synchronized cardioversion at 50 Joules
Administer IV Atropine 1mg push before shock
Shock delivered! Defibrillator discharges successfully. What is the immediate next step in the 2025/2026 ACLS algorithm?
Next Priority Action:
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Resume high-quality CPR (100-120 bpm) for 2 min + Epinephrine 1mg IV/IO
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Stop and recheck carotid pulse for 60 seconds before touching the chest
Administer Calcium Gluconate 10ml IV stat
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ROSC Achieved (Return of Spontaneous Circulation)
Patient Resuscitated!
Normal Sinus Rhythm restored (HR 82 bpm, BP 120/78 mmHg, SpO2 99%). Patient transferred safely to Cardiac ICU.
Code Blue Resuscitator
Mastered 2026 ACLS Arrest Protocol
+150 XP
Complete Resuscitation Debrief
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Arrest Protocol Timed Out
In cardiac arrest, every second without high-quality CPR or defibrillation drops survivability by 10%.
Retry Resuscitation Drill
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