The unified chain of survival is: early recognition, high-quality CPR, rapid defibrillation, advanced care, and post-arrest care, applying to all ages and settings. Focus on high-quality CPR, know your rhythm before administering epinephrine, match airway choice to your skill and resources, practice choking and opioid protocols, and always consider post-arrest stabilization and transfer.
Here is an excellent summary: Highlights of the 2025 American Heart Association Guidelines for CPR and ECC.
Epinephrine Timing: For non-shockable rhythms (asystole/PEA), give epinephrine as soon as feasible; for shockable rhythms (VF/pVT), give epinephrine after initial defibrillation attempts; high-dose epinephrine is not recommended. Note: Using vasopressin alone, or in combination with epinephrine, provides no benefit over epinephrine alone for adult patients in cardiac arrest.
IV Access Is Preferred: IO is a fallback if IV cannot be established, and access should be prepared early in the code.
Airway Management: Use ETI if skilled; otherwise, a supraglottic airway is acceptable. Ventilate once every six seconds with an advanced airway and monitor ETCO₂ or arterial pressure when available.
Defibrillation: Deliver a single shock followed immediately by CPR; use biphasic energy per manufacturer recommendations or maximum if unknown; double-sequential or vector-change defibrillation is not routine.
Cardioversion: For synchronized cardioversion of atrial fibrillation, starting at an initial energy of at least 200 J is reasonable, with subsequent increases if the initial shock is unsuccessful, depending on the defibrillator type.
Bradycardia: Unstable bradycardia refractory to medical therapy, temporary transvenous pacing is reasonable to increase heart rate and improve symptoms.
Choking/Airway Obstruction: Alternate 5 back blows with 5 abdominal thrusts until the airway is cleared; for infants, alternate 5 back blows with 5 chest thrusts.
Opioid-Related Arrest: Administer naloxone when overdose is suspected, but do not delay CPR.
Post-Arrest Care: Monitor for ROSC, manage temperature, assess neurological status, stabilize the patient, and prepare for ICU transfer as indicated.
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
We are excited to see so many of you join our FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!
Just a reminder… pay attention to the questions. Here are our general tips one more time:
