{
  "schema_version": 1,
  "kind": "condition",
  "id": "cardiac-arrest",
  "name": "Cardiac arrest",
  "category": "chronic",
  "sources": "Cardiopulmonary Resuscitation - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK470402/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class KD72.00 - condition scope only, no dose · Egyptian National Drug Formulary - Cardiovascular 2024 (adrenaline monograph, p227)",
  "review_status": "reviewed",
  "verified_against": "Cardiac arrest - disease-level clinical article (cardiac-arrest-clinical.txt) · Egyptian National Drug Formulary - Cardiovascular 2024 (adrenaline monograph, p227)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 361,
      "generic": "Adrenaline",
      "line": 1,
      "is_adjunct": false,
      "form": "injection",
      "strength_mg": 1.0,
      "adult_dose": "1 mg by slow intravenous injection, repeated every 3 to 5 minutes for as long as the arrest continues. The formulary recommends the 0.1 mg/mL solution for this route.",
      "adult_duration": "Repeated every 3 to 5 minutes throughout the resuscitation",
      "dose_source": "Egyptian National Drug Formulary - Cardiovascular 2024 (adrenaline monograph, p227)",
      "rationale": "The formulary lists cardiopulmonary resuscitation among the indications for adrenaline and gives 1 mg by slow intravenous injection every 3 to 5 minutes as required. The cited article gives the same: after failed defibrillation, adrenaline 1 mg intravenously, repeatable every three to five minutes. Compressions, airway and defibrillation come first and the drug replaces none of them - but a cardiac-arrest reference that prints no drug at all leaves out the one part of the algorithm that is a prescription.",
      "cautions": [
        "THE DRUG IS NOT THE FIRST THING. Chest compressions, an airway and defibrillation of a shockable rhythm come first; the cited article puts adrenaline after failed defibrillation.",
        "THIS IS AN AMBULANCE AND A HOSPITAL, NOT A CLINIC EPISODE. Call for emergency transfer at the same time as starting resuscitation.",
        "AMIODARONE BELONGS IN THE ALGORITHM AND IS NOT DOSED HERE. The cited article gives 150 mg over 10 minutes for recurrent electrical instability after failed defibrillation, and the formulary's amiodarone monograph gives 5 mg/kg over 20 to 120 minutes for arrhythmias. Neither is a bolus that can be delivered during an arrest, so no amiodarone row is printed - that dose comes from the resuscitation team.",
        "The formulary states there is no absolute contraindication to adrenaline in a life-threatening situation.",
        "The article names vasopressin as a recommended alternative, and states that calcium gluconate is not considered safe here - reserved for hyperkalaemia or a lethal dose of a calcium-channel blocker."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Neither source states a paediatric cardiac-arrest dose, so none is printed. What the formulary does state is given here with its own label rather than borrowed: for an infant, child or adolescent with symptomatic bradycardia unresponsive to atropine, adrenaline 0.01 mg/kg intravenously to a maximum of 1 mg per dose, repeatable every 3 to 5 minutes. A child in arrest is run on the paediatric resuscitation algorithm and the dose comes from the team running it.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "EPINEPHRINE-MEMPHIS 1 MG/ML 5 I.M./S.C. AMP.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 10.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ADRENAMAX 1 MG/1ML 10 AMPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CHEMIPHARM",
          "price_egp": 75.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "EPINEPHRINE-MISR 1 MG/ML 100 AMP.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR",
          "price_egp": 750.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ADRENALINE-CID 1 MG/1ML 100 I.M./S.C. AMP.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 850.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "cardiac-arrest"
    },
    {
      "id": 362,
      "generic": "Referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "An immediate life-threatening emergency requiring cardiopulmonary resuscitation. A GP's role is recognition, starting resuscitation, and calling for emergency transfer. The adrenaline above is part of the resuscitation, not a clinic prescription, and it comes after compressions, airway and defibrillation.",
      "adult_duration": "Refer, with advice",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": "An immediate life-threatening emergency requiring cardiopulmonary resuscitation. A GP's role is recognition, starting resuscitation, and calling for emergency transfer. The adrenaline above is part of the resuscitation, not a clinic prescription, and it comes after compressions, airway and defibrillation.",
      "cautions": [
        "Unresponsiveness, absent pulse, absent breathing.",
        "The drug rows above are what the treating service gives. They are here so that the referral is an informed one and so the GP can recognise the regimen the patient comes back on - not as permission to start it without the referral.",
        "RED FLAG - High-quality CPR requires starting chest compressions within 10 seconds of recognition, with a rate of 100-120 per minute and depth of 2-2.4 inches.",
        "RED FLAG - Identify and evaluate for reversible causes of cardiopulmonary arrest (the Hs and Ts: hypovolemia, hypoxia, hypothermia, hypo/hyperkalemia, acidosis, tension pneumothorax, cardiac tamponade, toxins, thromboembolism)."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children follow the same pathway: recognise, resuscitate, and get emergency transfer. Neither source states a paediatric cardiac-arrest dose, so none is printed on the adrenaline entry above.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "cardiac-arrest"
    }
  ]
}