Protocol 2-198 - Cardiac Arrest

Polk, Hickory, Cedar, & St Clair EMS Protocols




  • Attach Cardiac Monitor combo pads and limb leads.
  • Attempt to determine down-time, history, and DNR status.
  • EMT:




    Patient weight (lbs): (kg):

    NEMSIS Protocol: 9914055 - General-Cardiac Arrest


    Change Log:

    DateLink to
    Description of change
    10/04/13pdfSpecified faxing ePCR only to non-CMH facilities.
    01/29/14Added if at healthcare facility, scene may be cleared. Coordinated with CMH policies.
    12/12/14pdfCreated cardio cerebral resuscitation protocol.
    12/12/14pdfAdded comment that adults should receive 20 min of CPR before movement.
    12/14/14pdfReplace CPR with CCR.
    12/26/14Added Atropine, sodium bicarb, Amiodarone, Pacing, pediatric dosages.
    03/31/15Reverted to CPR per medical director.
    04/03/15pdfMoved Gastric Tube to Protocol 6-110 - Rapid/Delayed Sequence Intubation (RSI).
    05/31/15Added comment to refer to...
    11/17/15Added comment to perform continuous compressions with passive oxygen and basic airway for 3 cycles on witness arrest with a shockable rhythm based on 2015 AHA reccomendations. Added comment to consider biphasic energy doses. Added option for NPA in addition to OPA.
    11/17/15Added clarification for EMH vs CMH faxing ePCR after termination.
    02/03/16pdfAdded EMD section for MPDS medical direction.
    02/03/16pdfAdded EMD section for MPDS medical direction.
    02/06/16pdfAdded section for community responders. The intent of this addition is to provide standing protocols for community agencies and organizations to utilize for the use of their AEDs.
    02/06/16Added reference to AED protocol.
    07/22/16pdfMoved Narcan to AEMT section.
    07/01/17pdfModified compression rate from 100 to 110.
    07/26/17pdfChanged title from section to protocol.
    09/20/17Corrected typo where one location still indicated compression rate of 100 instead of 110.
    09/22/17pdfAdded calcium chloride for dialysis patient.
    09/22/17pdfAdded putrefaction as a sign of obvious death for EMD. Added prgnancy with fetus > 24 weeks as contraindication for field termination.
    12/26/17pdfPer Dr. Carter, removed requirement for DNR to be dated within 365 days.
    08/24/18pdfAdded option to drip Epi over five min.
    07/23/19pdfFixed typo.
    03/31/20pdfAdded content (without substantive modification)t from old Protocol 6-140 - Termination of Resuscitation.
    03/31/20Added content (without substantive modification) from old Protocol 6-060 - Do Not Resuscitate (DNR).
    03/31/20pdfAdded content from old Protocol 6-025 - Cardiopulmonary Resuscitation (CPR). Added pediatric dose of Amiodarone.
    03/31/20pdfAdded content (without substantive modification) from old Protocol 2-030 - Automated External Defibrillation.
    02/19/21pdfAHA 2020 updates to this protocol include no more 30:2 compression:ventilation ratio. All CPR is asynchromous at 110 per minute regardless of advanced airway placement. Capnography is indicated and required even if no airway is in place. IV is specifically called out as preferable to IO. Some clarification on cardiac arrest in pregnant patients that oxygenation and airway should be prioritized and fetal monitoring should not be done.
    03/25/21pdfMoved administration of epinephrine above links to PEA and VFib protocols.
    06/06/21pdfMoved to
    10/14/21pdfChanged link from 2-198-01 to 2-198-50.
    11/30/21Updated link to Albuterol.
    02/28/22Updated link for Sodium Bicarb.

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