ADVANCED CARDIOVASCULAR LIFE

SUPPORT.(ACLS)

OBJECTIVES.
1.

2.

3.
4.

5.

6.

7.

Recognize and initiate early management or periarrest conditions that

may result in cardiac aresst or complicate resuscitation outcome.
Demonstrate proficiency in providing BLS care, including prioriting
chest compression and integrating automated external defibrillator
(AED) use
Recognize and manage respiratory arrest.
Recognize and manage cardiac arrest until termination of resuscitation
or transfer of care, including immediate post-cardiac arrest care.
Recognize and initiate early management of ACS , including approriate
disposition.
Recognize and initiate management of stroke , including appropriate
disposition.
Demonstrate effective communication as a member or leader of a
resuscitation team and recognize the impact of team dynamics on
overall team performance.

ACLS SURVEY
ASSESS
AIRWAY
-is the airway
patent?
-is an advanced
airway indicated?
-is proper
placement of
airway device
confirmed?
-is tube secured
and placement
reconfirmed
frequently?

ACTION AS APPROPRIATE
- MAINTAIN AIRWAY PATENCY IN
UNCONCIOUS PATIENTS by use
the
head tilt-chin lift, oropharyngeal
airway
(OPA), or nasopharyngeal airway
(NPA)
- USE ADVANCED AIRWAY
MANAGEMENT IF NEEDED (e.g,
laryngeal mask airway, laryngeal
tube, esopharyngeal-tracheal
tube, endotracheal tube (ET tube)
- If use advanced airway devices:
- CONFIRM PROPER INTEGRATION
OF CPR AND VENTILATION.
- CONFIRM PROPER PLACEMENT OF
ADVANCED AIRWAY DEVICES.
- SECURE THE DEVICE TO PREVENT
DISLODGE.
-

CONT.
BREATHING
-are
ventilation
and
oxygenation
adequate?
-are
quantitative
waveform
capnography
and
oxyhemoglobi
n saturation
monitored?
CIRCULATION
-are chest
compression
effective?
-what is the

-GIVE SUPPLEMENTARY OXYGEN WHEN

INDICATED for cardiac arrest ,

administer 100% oxygen.For other,
titrate oxygen administration to
achieve > 94%
-MONITOR THE ADEQUACY OF
VENTILATION AND OXYGENATION by
cliical criteria
- AVOID EXCESSIVE VENTILATION.

MONITOR CPR QUALITY

ATTACH MONITOR/DEFIBRILLATOR OR
ARRHYTHMIAS OR CARDIAC ARREST
RHYTHM(e.g VF,pulseless
VT,asystole, PEA)
PROVIDE
DEFIBRILLATION/CARDIOVERSION

CONT.
-is
defibrillator
or
cardioversio
n indicated?
-has iv/io
access been
established?
-is ROSC
present?
-Is the
patient with
a pulse
unstable?
-are
medication
needed for
rhytym or
bp?
- Does the

GIVE IV/IO FLUID if needed.

CONT,
DIFFERENTIA
L DIAGNOSIS.
-why did this
patient
develop
symptoms or
arrest?

SEARCH FOR, FIND AND TREAT REVERSIBLE

CAUSES (ie, definitive care)

ACLS CASES

This case reviews appropriate

assessment, intervention, and
management option an unconscious,
unresponsive adult patient in respiratory
aresst. Respiration are completely absent
or clearly inadequate to maintain
effectively oxygenation and ventilation . A
pulse is present (Do not confuse agonal
gasp with adequate respirations).The BLS
Survey and ACLS survey are used even
though the patient is in respiratory aresst
and not in cardiac aresst.

BLS SURVEY.
ASESS

ASSESSMENT TECHNIQUE AND ACTION.

Check
responsivenes
s

-TAP AND SHOUT ARE YOU ALL RIGHT

-CHECK FOR ABSENT OR ABNORMAL BREATHING
(NO BREATHING OR ONLY GASPING) BY LOOKING
AT OR SCANNING THE CHEST FOR MOVEMENT
(ABOUT 5 TO 10 SECOND )

Activate the
emergency
response
system/get
AED.
CIRCULATION

-ACTIVATE THE EMERGENCY RESPONSE SYSTEM

AND GET AN AED IF ONE IS AVAILABLE OR SEND
SOMEONE TO ACTIVATE THE EMERGENCY
RESPONSE SYSTEM AND GET AN AED OR
DEFIBRILLATOR.
-CHECK THE CAROTID PULSE FOR 5 TO 10
SECOND
-If no pulse within 10 second, start CPR (30:2)
beginning with chest compressions.
-Compress the center of the chest (lower half
of the sternum)
hard and fast with at least 100 compression
per minute at a
depth of at least 2 inches.

CONT,
-switch provider about every 2 minutes to
avoid fatigue
-Avoid excessive ventilation
- If there is a pulse, start rescue breathing at 1
breath every 5 to 6 seconds (10 to 12 breaths
per minute).check pulse about every 2 minute.
DEFIBRILLATO
R

- -IF NO PULSE, CHECK FOR A SHOCKABLE

RYHTYM WITH AN AED/DEFIBRILLATOR AS
SOON AS IT ARRIVES.
- PROVIDE SHOCKS AS INDICATED
- FOLLOW EACH SHOCK IMMEDIATELY WITH CPR,
BEGINNING WITH COMPRESSION.

ALGORITHM.