Alteplase 0.6mg/kg IV push x1 given over 15 min (± heparin 5000 unit bolus), and then repeated 30 min after if still no ROSC
Heparin may be bolused with tPA or after ROSC obtained
Max doses of 50mg may be as efficacious as 100mg
Consider at least 20min of CPR after last dose of tPA before ending code
Heparin may be bolused with tPA or after ROSC obtained
Max doses of 50mg may be as efficacious as 100mg
Consider at least 20min of CPR after last dose of tPA before ending code
ACLS 2010 does not yet recommend routine thrombolytics (Class III)
CHEST 2012 and ACLS 2010 recommends in acute PE or high suspicion
Class IIc and Class IIa, respectively
2 hr infusion time recommended over long, 24hr (CHEST Class IIc)
Class IIc and Class IIa, respectively
2 hr infusion time recommended over long, 24hr (CHEST Class IIc)
Pulseless arrest
Spinal shock
Heat syncope
Cardiogenic shock
Electrical storm
Neurogenic shock
Hemorrhagic shock
Undifferentiated shock 