For apneic patients without a carotid pulse or patients with only gasping/agonal respirations, we will follow the Adult Cardiac Arrest algorithm.

For pulseless patients that the AED doesn't advise a shock, the patient's ECG shows asystole, or a non-perfusing organized rhythm (PEA), we will follow the right side of the Adult Cardiac Arrest algorithm.

Initial steps are aimed at delivery of high-quality CPR to keep the brain and vital organs alive. 

Epinephrine administration.

Placement of an advanced airway.

Considering possible reversible H & T causes of cardiac arrest including three common causes of PEA and their emergent interventions.

When we should discontinue resuscitation efforts and call the code.

Good luck with your ACLS class!

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

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Providing good, high-quality CPR with minimal interruptions and early defibrillation are two key interventions shown to improved cardiac arrest outcomes.

A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rate.

Characteristics of songs that will help us perform good CPR.

Advantages & disadvantages of using a song during CPR.

Selected songs from various genres and time periods from AHA's "Don’t Drop The Beat" playlist on Spotify.

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AHA's "Don’t Drop The Beat" playlist on Spotify at https://open.spotify.com/playlist/2mU2FNAhSOtQwW0hBgQMaK

A patient’s medical history will help us identify things that may be causing (or contributing) to their current condition as well as guide our decisions so we provide the safest evidence-based care possible.

Examples of information obtained in a medical history that will impact the treatment we provide.

There are several mnemonics and memory aids that people use to guide their history taking.

Review the SAMPLE-PQRST medical history format.

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Although magnesium can be used in the treatment of other medical conditions such as eclampsia, asthma, & digitalis toxicity; for ACLS, magnesium is primarily used to treat Torsades de Pointes.

Identification of Torsades on the ECG.

Administration of a magnesium infusion for stable patients vs slow IV push for patients in cardiac arrest.

Procainamide use for stable patients with a monomorphic wide-complex tachycardia.

Procainamide dosing and when to stop the infusion.

Tip for determining whether magnesium or Procainamide should be used when treating stable patients with V-Tach.

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When a patient loses excessive amounts of fluids, we say that they are in a state of hypovolemia.

The most obvious cause of hypovolemia is from bleeding.

Bleeding can be internal or external and caused by trauma, pathology, or iatrogenic.

Classic signs & symptoms of hypovolemic shock.

Volume replacement with crystalloids vs blood.

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MONA is the acronym sometimes used to help us remember the interventions to consider for patients with Acute Coronary Syndrome.

Morphine's use in the Acute Coronary Syndrome (ACS) algorithm.

Why Morphine is helpful for patients with ACS.

Contraindications and considerations for the safe administration of Morphine.

Morphine as an alternative to nitro for patients with chest pain that take PDE inhibitors.

Common dosing & administration of Morphine.

Monitoring of the patient's level of consciousness, pain, blood pressure, and respirations after administration.

Possible side effects of Morphine administration.

Narcan as an antidote to Morphine if needed.

Good luck with your ACLS class!

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Even good CPR is far less efficient at circulating blood than a functioning heart.

The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality

Summit in order of importance include:

• Chest compression fraction (CCF);
• Chest compression rate;
• Chest compression depth;
• Allowing for full recoil; and
• Adequate ventilations.

Using real-time feedback devices and ETCO2 to assess CPR quality.

Three tips to limit pauses in CPR compressions to 10 seconds or less.

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Epinephrine and Dopamine are adrenergic agonist used in several ACLS algorithms.

The use of epinephrine for severe anaphylaxis and unstable bradycardia.

Review epinephrine’s effects on blood vessels and bronchioles.

Why epinephrine is helpful for patients with anaphylaxis.

Using an epi drip for unstable bradycardia.

Epinephrine administration during cardiac arrest.

Starting an epinephrine or Dopamine drip for patients that have ROSC.

Review the effects of Dopamine based on mcg/kg/min dosing.

Monitoring the patient and titrating epi or Dopamine drips to prevent harm.

For more information on ACLS medications, check out the pod resource page at passacls.com.

Good luck with your ACLS class!

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Providing rescue breathing to apneic patients with a palpable pulse.

Normal end tidal CO2 for patients with a pulse.

Identification of cardiac arrest and our immediate actions.

Providing artificial ventilations during CPR without an advanced airway vs with an advanced airway in place.

Using quantitative waveform capnography to confirm placement of an advanced airway, assess the quality of CPR, and identify ROSC.

The effects of hyperventilating patients in cardiac arrest.

Good luck with your ACLS class!

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Hypothermic patients aren't dead until they are warm and dead.

When a patient’s core body temperature drops below 96.8 F (36 C), they are hypothermic.  As the body’s temperature drops below 36 C, hypothermia may further be classified as moderate or severe:

·    Moderate if the patient’s body core temp is between 30-34 C; and

·    Severe if it's below 30 C.

Modifying the ACLS Adult Cardiac Arrest algorithm for patients with severe hypothermia.

Following the ACLS algorithm for patients with a body core temperature above 30 C.

Methods for rewarming patients with moderate vs severe hypothermia.

Continuation of CPR and ACLS efforts until the patient’s body core temp is above 36 C.

Good luck with your ACLS class!

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