Reference

Algorithms

39 bedside algorithms written out step by step, with every decision point, dose and branch.

Reviewed by Alex G, BSN, RN, CEN, CCRN, CMC, NREMT-P · From the Reference tab of the app

First five minutes

• New HypotensionConfirm it, check perfusion, sort the cause, act while you call
• New HypoxemiaProbe, position and oxygen first; then DOPE or the bedside clues
• New Confusion or AgitationSafety, a quick neuro exam, then delirium and its causes
• Low Urine OutputCatheter first, then pressure, volume, the kidney and who to call
• New Fever in the ICUShock check, cultures, the source hunt and the mimics

Prehospital and transport

• Traumatic Cardiac ArrestBleeding, chest, airway, volume, then go: treat causes before compressions
• Field Triage of Injured PatientsWhere to take one injured patient: the 2021 national guideline, red then yellow
• Opioid OverdoseVentilate first, naloxone for breathing, CPR if no pulse
• Field Delivery and Newborn CareControlled birth, the first minute, then mother: dystocia and cord prolapse branches
• Agitated or Violent PatientSafety, words first, medical causes, then sedation that is monitored

Cardiac arrest and ACLS

• Adult Cardiac ArrestVF/pVT and asystole/PEA, two minutes at a time
• Bradycardia With a PulseSymptomatic bradycardia, step by step
• Tachycardia With a PulseUnstable vs stable, narrow vs wide
• STEMIFrom the 12-lead to reperfusion
• Arrest After Cardiac SurgeryShock or pace first, reopen the chest within 5 minutes
• VT StormRecurrent VT or VF and repeated ICD shocks
• Flash Pulmonary Edema (SCAPE)Sympathetic crashing pulmonary edema: NIV and high-dose nitroglycerin

Airway and respiratory

• Vent Alarm or Sudden DistressDOPE, then peak vs plateau
• Tracheostomy EmergencyBlocked or displaced tube, and the laryngectomy stoma (NTSP)
• Can't Intubate, Can't OxygenateFailed intubation to front-of-neck access
• Massive HemoptysisProtect the good lung, secure the airway, stop the source

Shock and circulation

• Sepsis: Hour-1 BundleFrom suspicion to pressors
• AnaphylaxisEpinephrine first, then support
• Massive Pulmonary EmbolismPE with shock or arrest: support the RV, then reperfuse

Hemorrhage and transfusion

• Massive HemorrhageActivating the massive transfusion protocol
• Postpartum HemorrhageQuantify and stage, treat the 4 Ts, escalate early

Neuro

• Stroke CodeLast known well, imaging, lytic and thrombectomy decisions
• Status EpilepticusBenzodiazepine, second-line drug, then anesthesia

Metabolic, toxicology and environment

• HyperkalemiaStabilize the heart, shift potassium in, remove it
• Malignant HyperthermiaStop the trigger, dantrolene, cool
• Local Anesthetic ToxicitySeizures, arrhythmias and lipid emulsion
• Accidental HypothermiaStage it, rewarm by stage, modified ACLS below 30 °C

Devices

• Impella AlarmsSuction, position, purge and stopped pump
• IABP AlarmsTrigger, gas, augmentation and position
• ECMO EmergenciesAir, decannulation, pump failure, low flow
• Unresponsive Patient With an LVADAssess perfusion before compressions
• CRRT Pressure AlarmsWhich pressure, what it means, first moves

Pediatrics

• Pediatric Cardiac Arrest (PALS)Weight-based shocks and drugs
• Pediatric Bradycardia With a PulseOxygenate first

For education and exam preparation only. Follow your institution’s protocols. Study aid with typical adult values; follow your local protocols and medical direction, and current AHA guidelines.