Version control: This document is current with respect to 2016 American Heart Association® Guidelines for CPR and ECC. Updated 2020 guidelines have been published by AHA, by enrolling in our courses you will receive the current learning materials (2016 guidelines) now and also AUTOMATICALLY have free access to the 2021 guidelines when available. Please note that our company typically implements new training guidelines up to a year before AHA releases their updates.

Management of a patient in cardiac arrest with asystole follows the same pathway as management of PEA. The top priorities stay the same: Following the steps in the ACLS Pulseless Arrest Algorithm and identifying and correcting any treatable, underlying causes for the asystole. The algorithm assumes that scene safety has been assured, personal protective equipment is being used, and no signs of obvious death are present.

Begin with the primary survey to assess the patient's condition:

Follow the ACLS Pulseless Arrest Algorithm for asystole:

IV/IO access is a priority over advanced airway management. If an advanced airway is placed, change to continuous chest compressions without pauses for breaths. Give 10 breaths per minute (once every 6 seconds) and check rhythm every 2 minutes.

Without a pulse or electrical activity on the ECG, the emergency care team needs to decide when resuscitation efforts should stop. The patient's wishes and the family's concerns need to be considered.