Anaesthesia · CPCR/BLS/ACLS Protocols

Regarding drugs in the current ACLS cardiac arrest algorithm, which statement is correct?

  • A Atropine has been removed from the cardiac arrest algorithm but remains indicated for symptomatic bradycardia
  • B Atropine is given routinely for asystole and slow PEA
  • C Atropine remains first line for PEA with heart rate below 60
  • D Atropine is now recommended as an alternative to adrenaline in all non-shockable rhythms
Correct answer: A. Atropine has been removed from the cardiac arrest algorithm but remains indicated for symptomatic bradycardia

Explanation

Trials showed no benefit of atropine in asystole or PEA, so it was deleted from the cardiac arrest algorithm. It retains its role in symptomatic bradycardia with a pulse at 0.5 to 1 mg IV, repeated to a maximum of 3 mg. This dual status, retained for bradycardia yet abandoned for arrest, is what makes options B and C tempting but incorrect.

Reference: AHA Guidelines for CPR and Emergency Cardiovascular Care, 2020 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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