ACLS on Repeat

(Verse 1 – Decision Point) Scene hits quiet, then everything flips No pulse on the patient, no rise in the lips First thing I ask before anything starts— DNR or MOST, we check it apart Living will, paperwork in hand If it says don’t start, then we follow that plan Deceased signs clear—rigor, decay We don’t bring back what nature took away But if there’s no DNR on the line We go full force, no wasting time (Chorus) CPR on repeat, no break in the chain Push hard, push fast through the pain 100 to 120, deep in the chest Less than ten seconds for every rest Ventilate slow, one breath each six While the team locks in their critical fix In cardiac arrest, we don’t slow down We run the algorithm, we own this ground (Verse 2 – Pit Crew Flow) Team assigned, no chaos here Every medic knows their gear Compressions rotate every two Before fatigue can break us in two AED or monitor comes alive Checking the rhythm to decide how we drive Asystole flat or PEA slow VF or VT ready to go Shockable rhythm—clear the scene Charge to 360 between compressions clean No shock for flatline, no wasted shock We follow the science, we follow the clock (Pre-Chorus) Airway open, but never delay Tube or BIAD, we don’t lose the way Compressions first, that’s rule number one Everything else comes after the run (Chorus) ACLS on repeat, don’t break the flow Every second matters more than we know Hands stay moving, chest stays deep In the silence, the algorithm speaks EtCO₂ watching every sign Tell us if we’re still on time From the street to the end of the line We’re fighting for a pulse in real time (Verse 3 – Reversible Causes) Now I’m thinking H’s and T’s What’s reversible underneath? Hypovolemia—give fluids wide Hypoxia—oxygen up inside Acidosis—ventilate, don’t delay Hypothermia warm them away Potassium swings high or low Calcium, bicarb start to go Tension pneumo—decompress fast Tamponade blocking every pass Toxins from beta or calcium block Thrombosis—PE or clot in shock Coronary MI shutting it down We chase the cause while circling around (Bridge – System Discipline) Do not hyperventilate the chest Ten breaths a minute, nothing more, nothing less Do not pause just to place a tube Compressions first, that’s what we do BIAD goes in if airway’s tight Video laryngoscope if we try it right If it fails once, we don’t repeat We go back to compressions, back to beat Pads on early, AP if we can Mechanical CPR if it fits the plan Around ten minutes if still no ROSC Hands off time is a cost we don’t risk EtCO₂ low, we fix the press EtCO₂ high, we reassess Above forty? That sudden rise Could mean life coming back to eyes (Chorus) ACLS on repeat, we don’t stop now We follow the rhythm, we take the vow Push, breathe, shock if it’s right Work the algorithm through the night From pit crew flow to the final call We do everything—we give it all Until ROSC or the line goes still We fight on instinct and trained will (Verse 4 – Special Scenarios) Maternal arrest, we change the stance Left uterine shift gives circulation a chance Dialysis patients, potassium risk Renal failure makes the rhythm twist Drowning or asphyxia, oxygen first Airway and ventilation break the worst Lightning, hanging, hypoxic states All need oxygen before it’s too late Pacing won’t help in arrest like this No shortcut here, no magic fix (Final Chorus – Outcome) AT ANY TIME, the rhythm can turn A spike on EtCO₂, a lesson learned But if it doesn’t, if silence stays We reach the end of resuscitative phase Termination on scene, protocol guide Notify hospital, stand outside Not every story comes back from flat And that’s the truth we never forget that (Outro) We pack the gear, lights fade slow Another name we came to know No pulse returned, no final beat— Just the weight of boots on an empty street.