Two things have changed in recent years to aid students that don't use ACLS in their daily practice.

1.  The role of the team leader; and

2.  The ability to use your quick reference cards.

The team leader is responsible for assigning tasks and overall direction of the team but can & should ask team members for help.

Using closed-loop communication to ensure the clarity of orders and speaking up if there’s any doubt about an order or action.

Use of your course’s approved text book and quick reference cards during the megacode and written exam.

Tips to help you pass the ACLS written exam.

Good luck with your ACLS class!

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Two factors to cardiac arrest survivability that have been clearly shown to make the biggest difference is continuous, high-quality CPR and early defibrillation.

The most common dysrhythmia present during the first few minutes of cardiac arrest.

The chance of successful defibrillation decreases every minute that passes.

How our chance of successfully defibrillating a patient into a perfusing rhythm significantly changes when good CPR is delivered vs when it isn't.

Why bystander CPR is important for out-of-hospital cardiac arrest (OHCA) outcomes. 

The role of the CPR coach.

Five tips to aid us in limiting CPR interruptions to less than 10 seconds so we can maintain a chest compression fraction (CCF) of at least 80%.

Good luck with your ACLS class!

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Quantitative waveform capnography is used in ACLS

• to objectively assess good CPR;
• confirm placement of an endotracheal tube;
• identify return of spontaneous circulation; and
• during post-cardiac arrest care.

We can use waveform capnography with, and without, an advanced airway in place.

Monitoring end tidal CO2 during rescue breathing.

Use of capnography to objectively measure good CPR.

Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code.

During CPR, a sudden increase in ETCO2 may indicate ROSC.

Quantitative waveform capnography use in the post-cardiac arrest algorithm.

Good luck with your ACLS class!

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Patients with a narrow complex tachycardia with a rate over 150 BPM are in SVT.

Unstable patients in SVT, or V-Tach with a pulse, should be cardioverted with a synchronized shock.

Assessment & treatment of stable tachycardic patients.

Commonly used vagal techniques.

A less common technique to stimulate the vagus nerve is the dive reflex.

Indications and use of Adenosine for stable patients in SVT refractory to vagal maneuvers.

Possible treatments for patients found to be in A-Fib or A-Flutter with RVR after administration of Adenosine.

Carotid sinus massage.

Additional medical podcasts that have episodes on tachycardia can be found on the pod resources page at passacls.com.

Good luck with your ACLS class!

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Remembering all the different energy setting needed for synchronized cardioversion and defibrillation used to be confusing for a lot of people.

Defibrillators can be broken down into three basic categories:

1.  Automated External Defibrillator (AED);

2.  Biphasic defibrillators; and

3.  Monophasic defibrillators.

Use of an AED to rapidly deliver a shock.

Advantages & use of Biphasic defibrillators.

For monophasic defibrillators, use 360J to defibrillate V-Fib or pulseless V-Tach.

AEDs must not be used on patients with a pulse.

Cardioversion of patients in unstable SVT or V-Tach with a pulse using biphasic vs monophasic monitor/defibrillators.

Team safety when performing synchronized cardioversion.

Energy needed to cardiovert unstable patients with a narrow vs wide complex tachycardia.

Good luck with your ACLS class!

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Patients with a heart rate less than 60 are bradycardic. Some people can have a resting heart rate in the 40s without any compromise.  For others, a heart rate of 50 or less could signify the need for immediate intervention and warrants additional assessment.

Signs & symptoms that indicate a bradycardic patient is unstable.

Monitoring oxygen saturation with pulse oximetry and indications for administration of oxygen.

Calcium channel blockers and beta blocker medication as treatable causes of bradycardia.

The indications and dosage of Atropine.

Precautions for Atropine use in patients with second or third degree AV blocks.

The use of transcutaneous pacing (TCP) for unstable bradycardic patients refractory to Atropine.

The use and dosing of Dopamine and Epinephrine drips.

For additional information about causes and treatment of bradycardia, check out the pod resources page at PassACLS.com.

Good luck with your ACLS class!

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The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.

Post-arrest care and recovery are the final two links in the chain of survival.

Identification of ROSC during CPR.

Initial patient management goals after identifying ROSC.

The patient’s GCS/LOC should be evaluated to determine if targeted temperature management (TTM) is indicated.

Patients that cannot obey simple commands should receive TTM for at least 24 hours.

Recently published studies on TTM and ACLS’s current standard.

Monitoring the patient’s core temperature during TTM.

Patients can undergo EEG, CT, MRI, & PCI while receiving TTM.

Good luck with your ACLS class!

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No statistical diff (TTM2 summary):  https://www.ahajournals.org/doi/10.1161/JAHA.122.026539

The chain of survival for ACLS is the same as was learned in your BLS class.

The beginning steps of the Cardiac Emergency and Stroke chain of survival.

ACLS's timed goals for first medical contact to PCI for STEMI and door-to-needle for ischemic stroke.

Characteristics of areas that have significantly better stroke and out-of-hospital cardiac arrest outcomes.

Good luck with your ACLS class!

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Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes.

When a patient’s potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively.

Two things that may lead us to suspect hypo or hyperkalemia.

Medical conditions & medications that can cause potassium imbalance.

ECG changes seen in hypo and hyperkalemia.

Critical lab values that would indicate a need for treatment.

Emergent, ACLS interventions for hypokalemia and hyperkalemia.

Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast.  Check out the pod resources page at passacls.com.

Good luck with your ACLS class!

Buy Me a Coffee at https://buymeacoffee.com/paultaylor

Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/

Safe Meds VIP - Learn about medication safety and download a free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip

Pass ACLS Web Site - Episode archives & other ACLS-related podcasts:  https://passacls.com

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When treating patients having an MI or stroke, more minutes equals more dead cells. 

Because the majority of strokes are the ischemic type, the treatment for stroke is similar to an MI – to reestablish perfusion to the ischemic tissues. 

The first four steps in the Stroke Chain of Survival.

Time criteria for the administration of tPA (or a similar fibrinolytic medication) or EVT of LVO strokes.

Stroke benchmarks for door to:

• assessment;
• completing a non-contrast CT; and
• administration of fibrinolytic medication such as tPA (door-to-needle).

EMS interaction with stroke teams and destination protocols to reduce time to definitive care.

The difference for timed goals for the identification & treatment of AMI vs Stroke.

Additional information about timed goals for stroke and how EMS affects outcomes, can be found on the PassACLS.com pod resources page.

Good luck with your ACLS class!

Buy Me a Coffee at https://buymeacoffee.com/paultaylor

Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/

Safe Meds VIP - Learn about medication safety and download a free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip

Pass ACLS Web Site - Episode archives & other ACLS-related podcasts:  https://passacls.com

@Pass-ACLS-Podcast on LinkedIn