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BLS Healthcare Provider Algorithm
(VF and Pulseless VT)

Using the BLS Healthcare Provider Algorithm for
Managing VF and Pulseless VT

Before proceeding, it is a good idea to view our terms.

If you would like to go to the main algorithms page, click here.

The BLS (basic life support) Primary Survey is used in all cases of cardiac arrest. For any emergency, you first see if the patient is responsive, call EMS, and find an AED. Next you go through the ABCDs. For this case, you assess a person without a pulse; you do not have an emergency care team to work with you.

Initial Assessment:


  • Make sure the scene is safe.
  • Tap shoulder and ask, "Are you all right?"
  • If the patient does not respond, call for help. Activate EMS
  • Get the automated external defibrillator (AED) or send someone for it, if someone is available.

Perform the ABCDs in the primary survey:


Airway Watch for the patient's chest to rise and fall.
Listen for air escaping.
Feel for expired air against your cheek.
Open patient's airway using the head-tilt, chin-lift or jaw thrust (if trauma is suspected)
Breathing Check breathing (take at least 5 seconds but not more than 10 seconds).
Patient is not breathing. Give 2 rescue breaths.
  • Use a barrier device if you have one.
  • Give each breath over 1 second.
  • Each breath should make the chest rise. Be careful not to hyperventilate the patient (rate too fast or volume too much).
Circulation Check the patient's carotid pulse (take at least 5 seconds but not more than 10 seconds).
No definite pulse? Start cycles of 30 chest compressions and 2 breaths until the AED arrives.
  • Push hard and fast (100/min) and release completely.
  • Perform compressions at a depth of 1.5 to 2 inches.
  • Let the chest to completely recoil.
  • Minimize interruptions.
Defibrillation using and AED After the AED arrives, attach AED pads to the patient's chest (see AED section for details).
Turn on the AED.
Follow prompts.
Check rhythm.
Is the rhythm shockable?
  • If the AED advises a shock, make sure bystanders or other helpers stay clear.
  • Give one shock.
Resume CPR immediately for 5 cycles (approximately 2 minutes). Check rhythm again. Give one shock. Repeat cycle of CPR.
If rhythm is not shockable, resume CPR immediately for 5 cycles.
Check rhythm every 5 cycles.
Continue until ALS providers take over or the patient starts to move.

Unclear if the patient has a pulse?

Begin CPR immediately. Do not waste time trying to be certain about a pulse. It is better to begin CPR that is unnecessary than to neglect compressions when they are needed. Applying CPR to a patient with a pulse is not harmful. However, delaying CPR for a pulseless patient reduces the patient's chances of being successfully resuscitated.