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.

Indications for starting TTM.

Monitoring the patient’s core temperature.

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

Good luck with your ACLS class!

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Chapters

0:00 Identifying ROSC

0:59 Additional ACLS Resources (https://passacls.com)

1:05 Save on prescription meds (https://safemeds.vip)

1:21 Post Arrest Assessment & Goals

3:04 Indications & Initiation of TTM

4:02 Two TTM Tips

4:50 Share Pass ACLS on LinkedIn

Nitroglycerine is vasodilator that affects peripheral blood vessels and coronary arteries.

Because of its widespread dilation effects on blood vessels, nitro can quickly lower a patient’s blood pressure, sometimes to the point of making a patient hypotensive.

Assessment of vital signs prior to administering nitro is necessary to ensure patient safety.

Indications for use of nitroglycerine.

Nitroglycerine's contraindications & considerations for use.

Effects of nitro on patients taking PDE inhibitors.

Administration of nitroglycerine to patients with ischemic chest pain.

Considerations for patients that took their home nitroglycerine.

Monitoring patient's pain and vital signs after nitro administration.

Good luck with your ACLS class!

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In atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) the electrical impulse for cardiac contraction is in the atria but isn't the normal pacemaker of the heart, the SA node.

The ECG characteristics of A-Fib and A-Flutter.

Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR).

Suggested energy settings for synchronized cardioversion of unstable patients with a narrow complex tachycardia.

Team safety when cardioverting an unstable patient in A-FIB/Flutter.

Adenosine’s role for stable SVT patients with underlying atrial rhythms.

Treatment of stable patients in A-Fib/Flutter with RVR.

For other medical podcasts that cover narrow complex tachycardias, visit the pod resource page at passacls.com.

Good luck with your ACLS class!

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As an ACLS provider you do not need to be familiar with all of the different signs of various types of poisoning.  You should be able to obtain a history and know to order toxicology.

The majority of toxins don’t have a specific antidote.  There are a few toxins for which we have emergency interventions and ACLS providers should be familiar with.

Reviewing the patient's medical history for indicators that may lead us to suspect a tablet/toxin cause of cardiac arrest.

Administration of Narcan for suspected narcotics overdose following the Opioid Associated Emergency algorithm.

Other common ACLS Tablet Toxin scenarios with possible treatments.

Medications commonly used to treat specific toxins that are regularly stocked on crash carts or carried in EMS med bags.

ACLS providers that suspect a specific toxin should consult with their Pharmacy or call Poison Control for treatment directions.

Good luck with your ACLS class!

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Poison Myths and Misconceptions on "The Pharmacists Voice" podcast:

https://www.thepharmacistsvoice.com/podcast/poison-myths-and-misconceptions-discussion-part-1-of-5-with-angel-bivens-rph-and-wendy-stephan-phd/

The Pharmacist’s Voice ® Podcast

https://www.thepharmacistsvoice.com/podcast/

AHA Journals: updated guidance for resuscitation of patients with cardiac arrest, respiratory arrest, and refractory shock due to poisoning

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001161

The ACLS algorithms are designed to make it easier to remember the key interventions we should deliver, and the order in which they should be delivered, to provide the best evidence-based care possible.

Generally speaking, if there’s a change in a patient’s condition, we should ensure we’re using the correct algorithm.

Three key points to remember when using ACLS algorithms:

1.  If a patient’s condition changes, we should do an assessment and use the algorithm that matches the patient’s current state.

2.  If an action was already done, we don’t need to repeat it.

3.  We only do actions that are clinically appropriate and within our scope of practice.

Walk through of an example mega code scenario with explanations of when and why we change to a different ACLS algorithm. 

Good luck with your ACLS class!

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Beta blocking medications attach to Beta receptors to inhibit or “block” the effects of epinephrine (adrenaline)and norepinephrine in the body.

The primary locations of Beta I, II, and III receptors.

Effects of epinephrine & norepinephrine’s stimulation of beta receptors on the heart.

Beta blockers effects on the heart.

When we should consider the use of beta blockers in the Acute Coronary Syndrome (ACS)and Tachycardia algorithms.

Contraindications to the use of beta blocker medications.

More detailed information about beta blocker’s mechanism of action and specific instances for their use can be found on the Pod Resource page at PassACLS.com.

Good luck with your ACLS class!

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This episode we are reviewing the use of advanced airways in the adult cardiac arrest algorithm.

When we should consider insertion of an advanced airway for patients in a shockable vs non-shockable rhythm.

In addition to an endotracheal tube (ETT), other ACLS advanced airways include the Laryngeal Mask Airway (LMA) and the Laryngeal Tube airway.

The advantages of using an advanced airway over basic airway maneuvers.

Use of end tidal CO2 waveform capnography to confirm placement and assess the adequacy of CPR.

Identification and management of a misplaced ET tube.

Good luck with your ACLS class!

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Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient’s vital organs and decreasing cerebral damage.

Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.

Indications for use of an antiarrhythmic after ROSC.

Determining which antiarrhythmic to use post cardiac arrest.

Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.

The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.

Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.

Good luck with your ACLS class!

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Discover medical podcasts with CE at https://conveymed.io

Hydrogen ions is on one of the Hs in ACLS's H&T reversible causes of cardiac arrest.  When considering hydrogen ions as a cause, what we’re looking at is the patient’s pH, or acid/base balance, and conditions that affect it.

The body's normal pH.

Using patient history, ABGs, & labs to determine acidosis or alkalosis.

Common conditions/causes that may lead us to suspect acidosis.

Common conditions/causes that may lead us to suspect alkalosis.

Correcting acidosis by changing the rate of ventilations.

The indications, dose, and considerations for use of Sodium Bicarbonate.

Treatment of alkalosis depends on the type (metabolic or respiratory) and is aimed at correcting the underlying cause.

Other podcasts that cover acid/base balance and conditions that cause acidosis or alkalosis can be found on the Pod Resource Page at PassACLS.com.

Good luck with your ACLS class!

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Being the team leader during a cardiac arrest is challenging.  Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology.

Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.

If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.

If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm.

An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered.

We will follow the algorithm until the patient has ROSC or we call the code.

Good luck with your ACLS class!

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

@Pass-ACLS-Podcast on LinkedIn