ACLSStudyGuide

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Pre-CourseSelf-AssessmentTheACLScoursenowhasamandatorypre-courseself-assessmentwithapassingscoreofatleast70%.Studentsmaytaketheself-assessmentasmanytimesasneeded.PleasebringyourassessmentresultswithyoutotheACLSclassoremailinadvancetoinfo@expresstraining.com.Instructionsforaccessingtheself-assessmentareincludedinyourregistrationconfirmation.

Pre-CourseVideosFollowthelinkinyourregistrationemailtoaccessthepre-courseself-assessment>enteraccesscodeACLS15&clicksubmit>DONOTclicklaunch…scrolldowntoaccessthevideosinstead.ACLSWrittenExamTheACLSProviderexamis50multiple-choicequestions,witharequiredpassingscoreis84%.AllAHAexamsarenow“openresource”whichmeansstudentmayusetheACLSmanual,studyguides,handoutsandpersonalnotesduringtheexam.UsingtheACLSProviderManualaheadoftimewiththeonlineresourcesisveryhelpful.BLSReview

AssessmentStepsforBLS1. Makesuresceneissafe2. Tap/shouttocheckforresponsiveness3. Callforhelpifpatientisunresponsive4. Checkforpulseandbreathingforatleast5butno

morethan10seconds5. Ifnopulse(ornotsureifthereisapulse)beginCPR

Compressions• Atleast2incheswitharatebetween100–120/min• Allowforfullrecoil• Lowerhalfofthebreastbone• PEtCO2(intubated)<10mmHgindicatespoorcompressions• Interruptionsincompressionsshouldbe<10seconds• Switchcompressorsevery2min.

BreathsDuringCPR• Ratioofcompressionstobreaths30:2• Eachbreathgivenover1second• Aneffectivebreathwillresultinvisiblechestrise• CPRwithETT:1breathevery6secondswith

continuouscompressions• VerifyETTplacementincode:waveformcapnography• Excessiveventilation=decreasedcardiacoutput

RescueBreathing• Forapatientwhoisnotbreathingorbreathingeffectively• Give1breathevery5-6seconds• Eachbreathgivenover1second• Aneffectivebreathwillresultinvisiblerise/fallofthechest• Excessiveventilationdecreasescardiacoutput• Difficultypositioningairwayforpatency,placeNPAorOPA• OPAPlacement=Measurefromthecornerofthemouthto

theangleofthemandibleACSandStroke

ACS-STEMI• Assessment:Pale,cool,diaphoretic,chestpain,

dyspnea,anxiety,hypotension,poorperfusion• Aspirin160-325mg• TimeframetostartCoronaryReperfusion<90min

Stroke• HeadCTwithin25min.(normalCTmayruleouthemorrhagic)• Tobetterfacilitatecare,notifyreceivinghospitalinadvance• IschemicStroke:startfibrinolytictherapyASAP• HemorrhagicStroke:neuroconsult

RRTandMET(RapidResponseTeam/MedicalEmergencyTeam)

• MET/RRTfocusesonpreventionofdeuteriationtocardiacarrest• Improvepatientcarebyidentifyingandtreatingearlyclinicaldeterioration

ACLSStudyGuide

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EffectiveTeamDynamics1. Clearrolesandresponsibilities:Teamleadershouldclearlydelegatetasks2. Knowingyourlimitation:Stayinscopeofpractice/askforanewroleifinappropriatelyassigned3. Constructiveinterventions:ifsomeoneisabouttomakeamistakeaddressthatteammemberimmediately4. Knowledgesharing5. SummarizingandRe-evaluation6. Closedloopcommunication:Repeatbacktheorder7. Mutualrespect

BradycardiaandTachycardia

BradycardiawithaPulse• Ifsymptomatic,giveAtropine,0.5mgevery3-5min,

maxtotaldoseof3mg(6doses)• Ifstable,12-leadandgetexpertconsultation

TachycardiawithaPulse

• Ifunstable,immediatesynchronizedcardioversion• Ifstable,12-leadandexpertconsultation• Ifstablew/narrowQRS:

• Adenosine1stdose6mg/2nddose12mg

CardiacArrest(NoPulse)

AssessmentFindings• Unresponsive• Nopulse&nobreathing• Mayhaveagonalgasps

pVT/VF

• CPRfirstandwhiledefibischarging• 1mgepinephrineq3-5min(alwaysfirst

medyougivewhenthepatientisdead)• Amiodarone1stdose300mg/2nd150mg• Only2shockablerhythmsincardiacarrest

ASYSTOLE/PEA

• CPRfirst• Notshockable• 1mgepinephrineq3-5min• IfnopulseandnotpVT,VF,or

asystole,thenyouhavePEA

ManualDefibrillation• Immediatelyafteryoushockàcompressions• Immediatelyifnoshockindicatedàcompressions• Whilesettingupdefibrillationtoshockà

compressions• ContinueCPRwhilethedefibischarging

PostResuscitation/AfterROSC1. Optimizeventilationandoxygenation2. TreatHypotension,SBP<90mmHg3. IfSTEMIàCathLab4. Ifunabletofollowcommand:targetedtemperature

management• 32-36Catleast24hours

TachycardiaRhythmswithaPulse

Stable=goodBPandgoodmentation/Unstable=lowBPandpoormentation

SinusTachycardia

AtrialFibrillation

SupraventricularTachycardia

MonomorphicVentricularTachycardia

AtrialFlutter

PolymorphicVentricularTachycardia

ACLSStudyGuide

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BradycardiaRhythmswithaPulse

Non-symptomatic=goodBPandgoodmentation/Symptomatic=lowBPandpoormentation

SinusBradycardia

2ndDegreeHeartBlock,Type2

1stDegreeHeartBlock

3rdDegreeHeartBlock

2ndDegreeHeartBlock,Type1

PulselessRhythms(CardiacArrest)

1stStartCPR|2ndShockpVT/VFImmediately|3rdEstablishIVAccess&giveEpi|4thTreatReversibleCauses(H/T)

PulselessVentricularTachycardia(Monomorphic) Asystole

PulselessVentricularTachycardia(Polymorphic)

PEA(PulselessElectricalActivity)

VentricularFibrillation

PEAisanyorganizedrhythmwithoutapulsethatisnotVForpVT