Advanced Cardiac Life Support (ACLS)
questions and answers
ACLS
Not just cardiac arrest, not just chest compressions... but all emergencies!
Multiple Treatment Algorithms
▪Cardiac Arrest
-Ventricular fibrillation/Ventricular Tachycardia
-Asystole/Pulseless Electrical Activity
-In Pregnancy
-In Suspected or Confirmed COVID Positive Patients
▪Post-Arrest Care
▪Perfusing Arrhythmias
-Symptomatic Bradycardia
-Adult Tachycardia with a Pulse
▪Opioid Associated Emergencies
Pediatric care in Pediatric Advanced Life Support (PALS)
ACLS recommendation background
Guidelines by the American Heart Association and the European Resuscitation Council
▪Evidence-based recommendations
▪Literature review by International Liaison Committee on Resuscitation (ILCOR)
▪Latest update to full guidelines in 2020
-2022 ILCOR Consensus Review
basic life support (BLS) focus on cardiac arrest
Early recognition of cardiac arrest
▪Is the patient responsive?
▪Look for breathing and check for a pulse
▪Activate the emergency response system
▪Get an automated external defibrillator (AED)
High quality cardiopulmonary resuscitation (CPR)
▪Chest compressions
▪Rescue breaths
Early defibrillation with AED
Goal to provide high-quality CPR until ACLS providers arrive or patient is responsive
, immediate CPR importance
Immediate bystander CPR and defibrillation within 3-5 minutes have resulted in survival rates of 41-74%
for witnessed ventricular fibrillation (VF) cardiac arrest
CPR + AED may double VF survival relative to early CPR alone
BLS ensures the most important interventions happen immediately in cardiac arrest!
No time devoted to IV access, oxygen, advanced airways, monitors, further diagnosis, or medication
with this level of care
ACLS Takes Care A Step Further...
First things first, just like in BLS…
▪Is the patient responsive? Do they have a pulse?
ACLS in-hospital initial emergency treatments
▪Give oxygen
▪Maintain patent airway or obtain an advanced airway
▪Attach monitor/defibrillator
▪Obtain IV access
▪Obtain vital signs, if a pulse is present
▪Initiate CPR
▪Further work-up/monitoring
▪Post-resuscitation care
When performing the ACLS algorithms, you ARE PART of the emergency response system
▪This ACLS team allows multiple interventions simultaneously
▪No less focus on immediate recognition, CPR, and defibrillation when appropriate
6 people in the room at a time at minimum
Airway and Breathing: No Advanced Airway
Assists with ventilation if apnea or agonal breathing
Bag mask ventilation if no advanced airway
▪30:2 compression - ventilation ratio applies
Devices to maintain airway patency
▪Oropharyngeal airway
questions and answers
ACLS
Not just cardiac arrest, not just chest compressions... but all emergencies!
Multiple Treatment Algorithms
▪Cardiac Arrest
-Ventricular fibrillation/Ventricular Tachycardia
-Asystole/Pulseless Electrical Activity
-In Pregnancy
-In Suspected or Confirmed COVID Positive Patients
▪Post-Arrest Care
▪Perfusing Arrhythmias
-Symptomatic Bradycardia
-Adult Tachycardia with a Pulse
▪Opioid Associated Emergencies
Pediatric care in Pediatric Advanced Life Support (PALS)
ACLS recommendation background
Guidelines by the American Heart Association and the European Resuscitation Council
▪Evidence-based recommendations
▪Literature review by International Liaison Committee on Resuscitation (ILCOR)
▪Latest update to full guidelines in 2020
-2022 ILCOR Consensus Review
basic life support (BLS) focus on cardiac arrest
Early recognition of cardiac arrest
▪Is the patient responsive?
▪Look for breathing and check for a pulse
▪Activate the emergency response system
▪Get an automated external defibrillator (AED)
High quality cardiopulmonary resuscitation (CPR)
▪Chest compressions
▪Rescue breaths
Early defibrillation with AED
Goal to provide high-quality CPR until ACLS providers arrive or patient is responsive
, immediate CPR importance
Immediate bystander CPR and defibrillation within 3-5 minutes have resulted in survival rates of 41-74%
for witnessed ventricular fibrillation (VF) cardiac arrest
CPR + AED may double VF survival relative to early CPR alone
BLS ensures the most important interventions happen immediately in cardiac arrest!
No time devoted to IV access, oxygen, advanced airways, monitors, further diagnosis, or medication
with this level of care
ACLS Takes Care A Step Further...
First things first, just like in BLS…
▪Is the patient responsive? Do they have a pulse?
ACLS in-hospital initial emergency treatments
▪Give oxygen
▪Maintain patent airway or obtain an advanced airway
▪Attach monitor/defibrillator
▪Obtain IV access
▪Obtain vital signs, if a pulse is present
▪Initiate CPR
▪Further work-up/monitoring
▪Post-resuscitation care
When performing the ACLS algorithms, you ARE PART of the emergency response system
▪This ACLS team allows multiple interventions simultaneously
▪No less focus on immediate recognition, CPR, and defibrillation when appropriate
6 people in the room at a time at minimum
Airway and Breathing: No Advanced Airway
Assists with ventilation if apnea or agonal breathing
Bag mask ventilation if no advanced airway
▪30:2 compression - ventilation ratio applies
Devices to maintain airway patency
▪Oropharyngeal airway
