Pass ACLS Tip of the Day
I'm Paul from PassACLS.com and I'm here to help you pass ACLS. Like an audio flash card, this podcast is intended to aid any medical professional preparing for an Advanced Cardiovascular Life Support (ACLS) class. Each three-to-nine minute episode covers one of the skills needed to recognize a stroke or cardiac emergency and work as a high performing team to deliver safe, quality patient care. Listening to a tip a day for a few weeks prior to your ACLS class will help cement the core concepts that have been shown to improve outcomes in patients suffering a heart attack...
Medication Review: Nitroglycerine
Nitroglycerine is vasodilator that affects peripheral blood vessels and coronary arteries.
Because of its widespread dilation effects on blood vessels, nitro can quickly lower a patient’s blood pressure, sometimes to the point of making a patient hypotensive.
Assessment of vital signs prior to administering nitro is necessary to ensure patient safety.
Indications for use of nitroglycerine.
Nitroglycerine's contraindications & considerations for use.
Effects of nitro on patients taking PDE inhibitors.
Administration of nitroglycerine to patients with ischemic chest pain.
Considerations for patients that took their ho...
Atrial Fibrillation/Flutter with RVR
In atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) the electrical impulse for cardiac contraction is in the atria but isn't the normal pacemaker of the heart, the SA node.
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 complex tachycardia.
Team safety when cardioverting an unstable patient in A-FIB/Flutter.
Adenosine’s role for stable SVT patients with underlying atrial rhythms.
Treatment of st...
Tablets & Toxins as a H&T Reversible Cause of Cardiac Arrest
As an ACLS provider you do not need to be familiar with all of the different signs of various types of poisoning. You should be able to obtain a history and know to order toxicology.
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/toxin cause of cardiac arrest.
Administration of Narcan for suspected narcotics overdose following the Opioid Asso...
Knowing When To Use Which ACLS Algorithm
The ACLS algorithms are designed to make it easier to remember the key interventions we should deliver, and the order in which they should be delivered, to provide the best evidence-based care possible.
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:
1. If a patient’s condition changes, we should do an assessment and use the algorithm that matches the patient’s current state.
2. If an action was already done, we don’t nee...
Beta Blocker Use in ACLS
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’s stimulation of beta receptors on the heart.
Beta blockers effects on the heart.
When we should consider the use of beta blockers in the Acute Coronary Syndrome (ACS)and Tachycardia algorithms.
Contraindications to the use of beta blocker medications.
More detailed information about beta blocker’s mechanism of action and specific instance...
Advanced Airways
This episode we are reviewing the use of advanced airways in the adult cardiac arrest algorithm.
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 include the Laryngeal Mask Airway (LMA) and the Laryngeal Tube airway.
The advantages of using an advanced airway over basic airway maneuvers.
Use of end tidal CO2 waveform capnography to confirm placement and assess the adequacy of CPR.
Identification and management of a misplaced ET...
Antiarrhythmic Use After ROSC
Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient’s vital organs and decreasing cerebral damage.
Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.
Indications for use of an antiarrhythmic after ROSC.
Determining which antiarrhythmic to use post cardiac arrest.
Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.
The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.
Links to other medical podcasts that cover antiarrhythmics and other AC...
Hydrogen Ions as a H&T Reversible Cause of Cardiac Arrest
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.
Common conditions/causes that may lead us to suspect alkalosis.
Correcting acidosis by changing the rate of ventilations.
The indications, dose...
Adult Cardiac Arrest Code Flow
Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using 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 Algorithm.
If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we w...
Aspirin Use in ACLS’s ACS & Stroke Algorithms
For patients exhibiting symptoms consistent with myocardial ischemia, Aspirin is the first medications we should consider along with morphine, oxygen, and nitroglycerine; if indicated & safe.
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 algorithm.
Good luck with your ACLS class!
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