# Cardiac arrest - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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) - Verified date: 2026-08 ## Verified against - Cardiac arrest - disease-level clinical article (cardiac-arrest-clinical.txt) - Egyptian National Drug Formulary - Cardiovascular 2024 (adrenaline monograph, p227) ## Treatment metadata - Adrenaline — 1 mg — injection - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text CARDIAC ARREST 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 against Cardiac arrest - disease-level clinical article (cardiac-arrest- clinical.txt), Egyptian National Drug Formulary - Cardiovascular 2024 (adrenaline monograph, p227) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Warning signs often precede arrest but go unrecognized, and many survivors have amnesia for the event [memory loss] - It is the stopping of effective breathing and circulation together - In an adult the cause is most often the heart itself SIGNS - what you find (4) - A head-to-toe assessment should begin immediately to shape the management plan - Loss of the carotid pulse is the classic diagnostic sign, though rescuers - lay or professional - often check it incorrectly [absent pulse] - Ventricular fibrillation is the rhythm in 50 to 80% of cases, which is why the shock is the treatment [shock] - Sustained ventricular tachycardia without a pulse is the least common mechanism of the four [tachycardia] TESTS (4) - CPR should never be paused for blood or radiologic tests; point-of-care glucose or potassium may be checked if it does not interrupt resuscitation - Point-of-care ultrasound can assess cardiac activity during ongoing CPR - Whatever the cause, starting compressions early with the monitor on is what tells you which pulseless pathway to follow - It can be reversed by compressions, by cardioversion or defibrillation, or by pacing IF NOT THIS - what else fits (1) - True arrest is pulseless and unresponsive; syncope, seizure, or drug overdose (e.g. opioids) can mimic it Source StatPearls "Cardiopulmonary Arrest in Adults" - disease-level clinical article Status traced to the source above Rx: Resuscitation | Main treatment RESUSCITATION 1. ADRENALINE [1st line] Adult 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. - Repeated every 3 to 5 minutes throughout the resuscitation Peds 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. Source Egyptian National Drug Formulary - Cardiovascular 2024 (adrenaline monograph, p227) Why 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. Caution 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. Egypt EPINEPHRINE-MEMPHIS 1 MG/ML 5 I.M./S.C. AMP. MEMPHIS 10.00 EGP ADRENAMAX 1 MG/1ML 10 AMPS. CHEMIPHARM 75.00 EGP EPINEPHRINE-MISR 1 MG/ML 100 AMP. MISR 750.00 EGP ADRENALINE-CID 1 MG/1ML 100 I.M./S.C. AMP. CID 850.00 EGP MAIN TREATMENT 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. - Refer, with advice Peds 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. Source No dose - referral pathway, no medicine given in primary care Why 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. Caution 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). Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)