Pass ACLS Tip of the Day

Accidental hypothermia is one of the Hs in ACLS’s reversible H&T cause of cardiac arrest. Hypothermic patients aren't dead until they are warm and dead. As the body’s temperature drops below 36° C, hypothermia may be classified as moderate or severe. Modifying the ACLS Adult Cardiac Arrest algorithm for patients with severe hypothermia. Following the ACLS algorithm for patients with a body cor...

The use of calcium channel blocker medications for tachycardias refractory to Adenosine and to lower the blood pressure of hypertensive stroke patients. Calcium is one of the ions that move across the cellular membrane during cardiac contraction and relaxation. The primary use of calcium channel blockers in ACLS. Use of calcium channel blockers for SVT refractory to Adenosine and A-Fib or A-Flutte...

Review the ACLS treatment goals and targeted temperature management (TTM) for post-arrest patients that have return of spontaneous circulation (ROSC). 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. Good...

Review the indications, contraindications, and safe administration of nitroglycerine to Acute Coronary Syndrome (ACS) patients with ischemic chest pain. Nitroglycerine’s effects. Assessment of vital signs prior to administering nitro. Indications for use of nitroglycerine. Nitroglycerine's contraindications & considerations for use. Use of nitro with patients taking PDE inhibitors. Administrat...

Identification of Atrial Fibrillation (A-Fib) & Atrial Flutter on the ECG and the treatment of unstable and stable SVT patients with A-Fib/Flutter. 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 compl...

Review of Tablets & Toxins as an ACLS H &T reversible causes of cardiac arrest with some specific, commonly encountered examples. 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/...

Why we use algorithms. 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. 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! Links: Buy Me a Coffee at https://buymeacoffee.co...

Review of when we should consider beta blocker use in ACLS's Acute Coronary Syndrome (ACS) & Tachycardia algorithms and when they're contraindicated. 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 st...

A review of advanced airway use in ACLS’s Adult Cardiac Arrest algorithm including: advantages, types, insertion, and monitoring ETCO2. 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. The advantages of using an advanced airway over basic airway maneuvers. Use of end...

Indications & use of an antiarrhythmic infusion of Amiodarone or Lidocaine for cardiac arrest patients that have return of spontaneous circulation (ROSC). Our primary focus immediately following return of spontaneous circulation (ROSC). Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardi...

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. Commo...

BLS & ACLS's Adult Cardiac Arrest algorithm makes it easier to act as team leader during a code by following 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 A...

Review of aspirin's mechanism of action, indications, contraindications, and administration for patients with acute coronary syndrome (ACS) or stroke. Aspirin's mechanism of action & benefits for Acute Coronary Syndrome (ACS) patients. Contraindications and considerations for aspirin’s use. The dose and route of administration of aspirin for ACS patients. The use of aspirin in the ACLS Stroke...

Review of lead II ECG characteristics, rules to identify first and third degree heart blocks, and treatment following the ACLS Bradycardia algorithm. To pass ACLS, you will need to be able to identify common rhythms on a monitor during your mega code and ECG strips on your written exam. Review of normal ECG morphology in lead II. Characteristics of first-degree heart block. Characteristics of thir...

Review of antiarrhythmic medications Amiodarone & Lidocaine for use in ACLS's Adult Cardiac Arrest, Post Arrest, and Tachycardia algorithms. The two first-line ACLS antiarrhythmics that are generally used. Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Use of anti...

Review the indications, contraindications, sizing, and insertion of the nasopharyngeal airway (NPA) to maintain the airway of patients with a gag reflex. The tongue is the most common airway obstruction in an unconscious patient. When the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA). Examples of when a NPA should be considered. Contraindications an...

The causes, physiology, signs & symptoms, and treatment of cardiac tamponade as an ACLS H&T reversible cause of cardiac arrest. When blood, or other fluids, accumulate in the sac around the heart it’s called a cardiac tamponade or pericardial tamponade. The effects of tamponade on the electrical system and chambers of the heart. Cardiac tamponade can be acute or chronic and caused by traum...

The role of team leader, code team responsibilities, and the use of reference cards during your ACLS class megacode and written exam. Two things have changed in recent years to aid students that don't use ACLS in their daily practice. The team leader’s roles and responsibilities. Using closed-loop communication and speaking up if there’s any doubt about an order or action. Use of your course’s app...

Early CPR and defibrillation improve cardiac arrest outcomes. Here's why CPR is important and five ACLS tips to reduce CPR interruptions. Two factors to cardiac arrest survivability that have been clearly shown to make the most difference. The most common dysrhythmia present during the first few minutes of cardiac arrest. How our chance of successfully defibrillating a patient into a perfusing rhy...

The use of quantitative waveform capnography in ACLS to confirm good CPR and placement of an ET tube, identify ROSC, and during post-cardiac arrest care. Waveform capnography use 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)...

Review of vagal maneuvers and alternative treatments used in ACLS for stable patients with tachycardia at a rate over 150 bpm. Narrow complex tachycardia with a rate over 150 BPM. 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 st...

Review the energy settings needed for defibrillation and/or synchronized cardioversion using an AED, biphasic, or monophasic defibrillator. Defibrillators three basic categories. Use of an AED to rapidly deliver a shock. Advantages & use of biphasic defibrillators. Energy for monophasic defibrillators to defibrillate V-Fib or pulseless V-Tach. AED safety. Cardioversion of patients in unstable...

Bradycardia review including: stable vs unstable patients; assessment & monitoring; and ACLS treatment with Atropine, TCP, Dopamine, & Epinephrine drips. 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...

Review the ACLS treatment goals and targeted temperature management (TTM) for post-arrest patients that have return of spontaneous circulation (ROSC). The goal of CPR. 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 ta...

Review the chain of survival for cardiac and stroke emergencies and describe why strong EMS relations and specialized teams have better patient outcomes. 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...