Adult VF/Pulseless VT (ACLS) — free guideline decision tool
This tool summarizes ACLS management of adult shockable rhythms (VF/pulseless VT): defibrillation energy, epinephrine timing, and antiarrhythmic dosing, per AHA 2025.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Current situation | Refractory (still VF/pVT after ≥ 2–3 shocks + epinephrine) |
|---|
→VF/pulseless VTAntiarrhythmic + continued resuscitation
- Amiodarone：300 mg IV/IO bolus (first dose) → if no conversion, another 150 mg
- Lidocaine (alternative)：1–1.5 mg/kg IV/IO first dose, repeat 0.5–0.75 mg/kg if needed (equivalent to amiodarone, choose one, do not combine [unverified])
- Continue：Continue high-quality CPR + epinephrine every 3–5 min + interval defibrillation; consider double-sequential defibrillation, reversible causes (e.g. acute coronary occlusion → emergent PCI, electrolytes, ECPR)
| Current situation | VF/pulseless VT (during resuscitation) |
|---|
→VF/pulseless VTShock + CPR + epinephrine
- Immediate defibrillation：Single shock: biphasic 120–200 J (per manufacturer; if unknown use maximum) first, then equal energy, higher energy may be considered; monophasic 360 J. Resume high-quality CPR immediately after the shock (do not stack shocks)
- CPR：Compressions 100–120/min, depth 5–6 cm [unverified], full recoil, minimize interruptions; recheck rhythm after each 2-minute cycle
- Epinephrine：1 mg IV/IO every 3–5 minutes (give after the 2nd shock in a shockable rhythm)
Common questions
What is Adult VF/Pulseless VT (ACLS)?
This tool summarizes ACLS management of adult shockable rhythms (VF/pulseless VT): defibrillation energy, epinephrine timing, and antiarrhythmic dosing, per AHA 2025.
How is Adult VF/Pulseless VT (ACLS) calculated? What is the core formula?
Branches: shock (biphasic 120–200 J + CPR + epinephrine 1 mg q3–5min) → refractory (amiodarone 300→150 mg or lidocaine 1–1.5 mg/kg, treat 5H5T) → torsades (magnesium) → ROSC (post-arrest care, TTM, reversible causes).
When is Adult VF/Pulseless VT (ACLS) used?
Use during resuscitation to anchor the sequence — immediate single defibrillation with high-quality CPR, epinephrine every 3–5 minutes, antiarrhythmics for refractory arrest, magnesium for torsades, and structured post-ROSC care.
What are the key clinical points for Adult VF/Pulseless VT (ACLS)?
Defibrillate as a single shock then immediately resume CPR without stacking shocks; give epinephrine after the second shock in shockable rhythms. (original synthesis · not guideline verbatim) Amiodarone and lidocaine are equivalent options for refractory VF/pVT — choose one, do not combine [unverified]. Torsades/polymorphic VT with long QT is treated with magnesium sulfate plus correction of K/Mg and removal of QT-prolonging drugs.
What are the limits and cautions when using Adult VF/Pulseless VT (ACLS)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
Does Adult VF/Pulseless VT (ACLS) upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is Adult VF/Pulseless VT (ACLS) calculated in practice? Can you show a worked example?
Inputs: Current situation Refractory (still VF/pVT after ≥ 2–3 shocks + epinephrine) → Result: VF/pulseless VT Antiarrhythmic + continued resuscitation（Amiodarone: 300 mg IV/IO bolus (first dose) → if no conversion, another 150 mg, Lidocaine (alternative): 1–1.5 mg/kg IV/IO first dose, repeat 0.5–0.75 mg/kg if needed (equivalent to amiodarone, choose one, do not combine [unverified]), Continue: Continue high-quality CPR + epinephrine every 3–5 min + interval defibrillation; consider double-sequential defibrillation, reversible causes (e.g. acute coronary occlusion → emergent PCI, electrolytes, ECPR)） Inputs: Current situation VF/pulseless VT (during resuscitation) → Result: VF/pulseless VT Shock + CPR + epinephrine（Immediate defibrillation: Single shock: biphasic 120–200 J (per manufacturer; if unknown use maximum) first, then equal energy, higher energy may be considered; monophasic 360 J. Resume high-quality CPR immediately after the shock (do not stack shocks), CPR: Compressions 100–120/min, depth 5–6 cm [unverified], full recoil, minimize interruptions; recheck rhythm after each 2-minute cycle, Epinephrine: 1 mg IV/IO every 3–5 minutes (give after the 2nd shock in a shockable rhythm)）
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This tool summarizes ACLS management of adult shockable rhythms (VF/pulseless VT): defibrillation energy, epinephrine timing, and antiarrhythmic dosing, per AHA 2025.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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