PH-ACC
Prehospital Advanced Cardiac Care
Same Patient…Diffrent Environment
2026 EMS-Driven ACLS
Active Protocol1. ARREST IDENTIFICATION
UNRESPONSIVE
APNEIC / GASPING
PULSELESS
mCPR BRIDGE DEPLOYMENT
Required for extrication & transit
Movement
< 3 Personnel
Long Transit
Initial Phase: Airway & Oxygen
High-Flow BVM
15 LPM
SGA Priority
Subglottic SGA
SHOCKABLE
VF / Pulseless VT
SHOCK (360J)
Epi: HOLD during shock phase
Amiodarone 300mg
NON-SHOCKABLE
Asystole / PEA
Search for Motion
Use POCUS to identify Pseudo-PEA
Reversible Causes
H’s: Vol, Hypoxia, Ion, HyperK
T’s: Tox, Tamp, Pneumo, Throm
ROSC ACHIEVED
SPO2: 92-98%
ETCO2: 35-45
MAP > 65