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AHA ACLS UPDATE (Part 4)

1. The document outlines the steps of BLS survey, including checking responsiveness, activating emergency response, checking pulse, and defibrillation if indicated. 2. It emphasizes high quality CPR with a rate of at least 100 compressions per minute and depth of at least 2 inches, as well as minimizing interruptions and avoiding excessive ventilation. 3. The post-cardiac arrest algorithm goals are to identify and treat the cause of arrest, optimize organ function, induce therapeutic hypothermia, and monitor with capnography among other interventions.

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Pagente, Sofia Lorrene W.
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166 views3 pages

AHA ACLS UPDATE (Part 4)

1. The document outlines the steps of BLS survey, including checking responsiveness, activating emergency response, checking pulse, and defibrillation if indicated. 2. It emphasizes high quality CPR with a rate of at least 100 compressions per minute and depth of at least 2 inches, as well as minimizing interruptions and avoiding excessive ventilation. 3. The post-cardiac arrest algorithm goals are to identify and treat the cause of arrest, optimize organ function, induce therapeutic hypothermia, and monitor with capnography among other interventions.

Uploaded by

Pagente, Sofia Lorrene W.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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AHA ACLS UPDATE ADVANCED CARDIAC LIFE SUPPORT

CARDIAC ARREST ALGORITHM


4 STEPS OF THE BLS SURVEY:
1. Check responsiveness
a. Tap and shout, “Are you alright?”
b. Scan the chest for movement
2. Activate the emergency response system
and get an AED
3. Check the carotid pulse; DO NOT spend >
10 sec checking for pulse!
a. If with pulse – support with rescue
breathing (1 every 5-6 sec)
b. If no pulse within 10 seconds – begin
CPR (30 compressions: 2 ventilations)
4. Defibrillation
a. Connect AED and deliver a shock if
indicated
b. One shock protocol for VF and
pulseless VT

HIGH QUALITY CPR


PUSH HARD, PUSH FAST!
- Rate of at least 100 chest compressions
per minute – PUSH FAST!
- Compression depth of at least 2 inches
(adult) – PUSH HARD!
- Allow chest recoil after each compression
- Switch rescuers every 2 min – prevent
fatigue
- Minimize interruptions in compressions MEDICATIONS:
- Avoid excessive ventilations 1. Administer vasopressors every 3-5 min
o Effects: 2. Vasopressin can replace the 1st or 2nd
 Gastric inflation dose of epinephrine
 Increased intra-thoracic 3. Administer amiodarone for refractory VF
pressure and VT
 Decreased venous return 4. Atropine no longer recommended for use
 Lower cardiac output in PEA or asystole
o For arrest patients: 5. Tachycardia – may use adenosine
 Tidal volume – 500-600 ml 6. Bradycardia – IV infusion of chronotropic
 Half a bag squeeze or agents when atropine is ineffective
enough to see the chest
rise SYNCHRONIZED CARDIOVERSION
Unstable Atrial Fibrillation:
WAVEFORM CAPNOGRAPHY - Initial biphasic dose – 120-200 J
- Less than 10 mmHg will not achieve Unstable Monomorphic VT
ROSC - Initial dose – 100 J
- Intra-arterial relaxation pressure < 20
mmHg – ineffective compressions
POST CARDIAC ARREST ALGORITHM - Should not be confused with normal
Goals: breathing
1. To provide guidance for prehospital
personnel in transporting the out-of-hospital Reference:
patient to an appropriate facility with post-
cardiac arrest care AHA 2010 Guidelines
2. To provide guidance to hospital personnel
for transporting the patient to a critical care
unit capable of providing post-cardiac arrest
care
3. To identify and treat the causes of the arrest
and prevent a recurrence
4. To optimize cardiopulmonary function and
vital organ perfusion – especially to the
brain and heart

Other Objectives:
1. Considering therapeutic hypothermia to
optimize survival and neurologic recovery
2. Identifying and treating acute coronary
syndromes
3. Reducing the risk of multiple-organ injury
4. Gathering data to assess recovery
5. Offering rehabilitation services to survivors if
needed

Key Interventions:
1. Induction of therapeutic hypothermia
2. Monitoring with quantitative waveform
capnography
3. Acquisition of a 12-lead ECG
4. Monitoring of O2 sat values
5. BP optimization
6. Determination of blood chemistry values

AIRWAY MANAGEMENT
1. Waveform capnography
- monitors the amount of carbon dioxide
exhaled by the patient
- Most reliable indicator of ET tube position
- Effectiveness of chest compressions
- ROSC
- Adequate coronary perfusion
2. Cricoid Pressure
- DO NOT routinely use to prevent
aspiration
3. Agonal gasps
- NOT EFFECTIVE BREATHS

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