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ACLS Megacode:

Initial Assessment:
Check for responsiveness, breathing, and pulse.
If unresponsive, call for help and initiate CPR.
Attach defibrillator pads and monitor.

CPR:
Perform chest compressions at a rate of 100120/min, allowing full chest recoil.
Provide rescue breaths at a ratio of 30:2.
Continue CPR until ROSC is achieved or until medical help arrives.

Defibrillation:
If VF/VT is present, deliver a defibrillation shock of 360 joules biphasic or 360 joules monophasic.
If unsuccessful, increase the energy level to 400 joules biphasic or 400 joules monophasic and repeat.
Continue defibrillation attempts until ROSC is achieved or until medical help arrives.

Emergency Medications:
Epinephrine: 1 mg IV/IO every 35 minutes.
Vasopressin: 40 units IV/IO every 35 minutes (if refractory to epinephrine).
Amiodarone: 300 mg IV/IO over 20 minutes (if refractory to defibrillation).
Lidocaine: 1 mg/kg IV/IO (if refractory to defibrillation).
Sodium bicarbonate: 1 mEq/kg IV/IO (if metabolic acidosis).
Calcium chloride: 10 mg/kg IV/IO (if hyperkalemia or calcium channel blocker overdose).

Advanced Airway Management:
Intubate the patient if CPR is ineffective or if the patient is unable to maintain a patent airway.
Consider cricothyrotomy if intubation is unsuccessful.

PostROSC Care:
Monitor vital signs closely.
Provide supportive care, including oxygen therapy, fluid resuscitation, and antibiotics.
Address any underlying medical conditions that may have contributed to the arrest.