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To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block.
One method of ECG rhythm identification is to ask a series of questions such as:
What's the rate (<60, 60-100, 101-149, or >150);Is the rhythm regular or irregular;What's the shape, width, and frequency of P waves and QRS complexes; andWhat's the P-R interval and is it constant?ECG characteristics of a second-degree Mobitz type I (Wenckebach).
Identification of unstable bradycardia and its treatment with Atropine.
ECG characteristics of a second-degree Mobitz type II.
Possible effect of using Atropine on patients with a second-degree type II AV block.
Treatment of unstable bradycardic patients refractory to Atropine using TCP, Dopamine, or Epinephrine drip.
Starting dose and titration of Dopamine and Epinephrine drips.
Connect with me:
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Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
The Curious Clinicians Podcast: History of Doctor Wenckebach & Mobitz at https://curiousclinicians.com/2022/07/06/episode-52-way-back-wenckebach/
Practice ECGs with rationale at Dialed Medics at https://dialedmedics.com/
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When treating patients with Acute Coronary Syndrome (ACS), MONA is an acronym sometimes used to help us remember the initial interventions.
The O in MONA is Oxygen.
When we should administer oxygen to ACS patients.
When O2 administration is unnecessary based on an accurate pulse ox.
Monitoring patient's oxygen saturation (SaO2) using a pulse oximeter.
Review two common ACLS pre-arrest mega code scenarios.
Oxygen administration during CPR and post cardiac arrest.
You can find additional medical podcasts that cover ACLS-related topics, on the Pod Resources page at PassACLS.com
Connect with me:
Website: https://passacls.com
@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
Check out ConveyMed.io for more free online medical education (FOAMed) opportunities.
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Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes.
How do we know if high quality, effective CPR is being performed?
Objective measures of high-quality CPR include:
Compression rate;Compression depth & recoil;ETCO2; and Chest Compression Fraction (CCF).The role of the CPR Coach on the code team.
The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions.
The use of end tidal waveform capnography. (ETCO2)
A no-tech way to monitor effective CPR if no compression feedback device or ETCO2 capnography isn’t available.
Connect with me:
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@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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When we should use the bradycardia algorithm.
The signs & symptoms of unstable bradycardia.
Atropine's bradycardic dose and maximum.
The use of atropine when a patient is in a second degree type II or third degree heart block.
ECG changes that indicate subsequent doses of atropine are likely to be ineffective.
The starting dose of Dopamine.
The use of Dopamine for bradycardia as an interim until TCP vs hypotension.
The use of Atropine and Dopamine in patients with myocardial ischemia.
Podcasts with additional (advanced-provider level) information about bradycardia, Atropine, & Dopamine can be found on the Pass ACLS Pod Resources page.
Connect with me:
Website: https://passacls.com
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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The tongue is the most common airway obstruction in an unconscious patient.
Insertion an oropharyngeal airway helps keep the patient’s tongue from falling to the back of the pharynx, causing an airway obstruction.
The oropharyngeal airway is sometimes called an OPA or simply an oral airway.
Indications for using an oral airway.
Contraindication for an oral airway and an alternative airway that can be used for patients with an intact gag reflex.
Measuring an OPA and possible complications from inserting one that's too small or too large.
Two techniques to properly insert an OPA.
The use of an oral airway during CPR.
The use of an OPA as a bite block after a patient has an advanced airway placed.
Connect with me:
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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Hypoxia is a state of low oxygen levels in the blood.
Determining hypoxia using a pulse oximeter or arterial blood gasses (ABGs).
A goal of ACLS is to recognize signs of hypoxia and provide timely treatment to prevent an arrest.
Examples of some things that might lead us to think of hypoxia as a cause of cardiac arrest.
Why we should not rely on pulse ox to give accurate readings during CPR.
Delivering ventilations with near 100% oxygen concentration using a BVM attached to supplemental O2 and a reservoir.
Using end tidal waveform capnography to assess the quality of CPR.
Changes to ventilation rates, tidal volume, and O2 concentration affects a patient's oxygen, carbon dioxide, and pH.
The danger of excessive ventilation of a patient in cardiac arrest.
Connect with me:
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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ECG characteristics of supraventricular tachycardia (SVT) vs. sinus tachycardia.
Signs & symptoms that indicate a patient is unstable.
Delivery of a synchronized shock for the treatment of unstable SVT using a biphasic vs monophasic defibrillator.
Consideration for team safety while performing synchronized cardioversion.
Actions to take immediately if an unstable patient we’ve cardioverted goes into a pulseless rhythm.
Management of stable patients in SVT.
For more FOAMed on narrow complex tachycardias, check out the pod resource page at passacls.com.
Connect with me:
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@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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When working to resuscitate a patient in sudden cardiac arrest, Epinephrine is the first IV medication we administer.
When we give the first dose of epinephrine depends on whether the patient is in a shockable or non-shockable rhythm.
When to give the first dose of epinephrine and its frequency for patients in asystole or PEA following the right side of the Adult Cardiac Arrest algorithm.
When to give the first dose of epi and its frequency for patients in V-Fib or pulseless V-Tach following the left side of the Adult Cardiac Arrest algorithm.
Example chronology of events for a scenario where a patient is found unresponsive with only gasping/agonal breathing.
Administration of epi via the IO or endotracheal route in the absence of an IV.
The maximum cumulative dose of epinephrine that can be administered to patients in cardiac arrest.
When do we stop administering epinephrine.
Connect with me:
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it’s possible they could be having a stroke.
The Cincinnati Prehospital Stroke Scale.
There are several conditions that can mimic a stroke.
Identification & Treatment of hypoglycemia or hyperglycemia.
Identification & Treatment of hypoxia using a pulse oximeter.
Some seizures, electrolyte imbalance, sepsis, brain tumors, and Bell’s Palsy can also mimic a stroke.
Prehospital providers should transport suspected stroke patients to a stroke center following their local protocols.
Hospital providers should active their stroke team to ensure rapid assessment and treatment.
Connect with me:
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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Most ACLS medications are given IV push. But, what happens if we can't get an IV?
Why IO is better than ETT as an alternative route.
The locations we should place an IO when running a code and a location we should avoid.
The ACLS medications that can be given intraosseous.
Where you can find more information about intraosseous access during resuscitation efforts.
In the absence of an IV or IO, some medications may be given down the endotracheal tube.
The disadvantages of medication administration via ETT.
Review of the medications that can be given down the tube and how they should be given.
Medications should not be given down the tube when anything other than an endotracheal tube is used as an advanced airway.
Connect with me:
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@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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The chain of survival for a cardiac emergency and stroke start the same:
1. preparedness & recognition of an emergency;
2. activation of EMS;
3. delivery of Advanced Life Support; and
4. transporting to the most appropriate facility.
ALS ambulances are staffed with paramedics who have training in ACLS skills.
Why EMS "Destination Protocols" for suspected stroke and STEMI make a difference.
ACLS’s timed benchmarks for:
point of first medical contact to PCI for ST elevation MI;door to tPA for ischemic stroke; andonset of symptoms to EVT for LVO strokes.Why EMS should bypass a close hospital to transport a STEMI or suspected stroke patient to a hospital capable of 24/7 PCI or a certified stroke center.
Check out the Pod Resource page at passacls.com for links to the "EMS On Air" podcast for links to episodes that look at EMS's role in stroke outcomes in the rural vs urban area.
Connect with me:
Website: https://passacls.com
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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Performing good CPR and delivering a shock as soon as possible to a patient in Ventricular Fibrillation or pulseless V-Tach are the two most critical interventions that have been shown to increase survival from sudden cardiac arrest.
Studies have demonstrated significantly better out-of-hospital cardiac arrest survival outcomes in communities with robust public CPR training and public access/first responder AEDs.
The general use of AED including:
indications for use; attaching the AED pads; following verbal prompts; and safely administering a shock.Following the Adult Cardiac Arrest algorithm while using an AED.
Contraindications to AED use.
General safety considerations to remember.
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Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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For apneic patients without a carotid pulse or patients with only gasping/agonal respirations, we will follow the Adult Cardiac Arrest algorithm.
For pulseless patients that the AED doesn't advise a shock, the patient's ECG shows asystole, or a non-perfusing organized rhythm (PEA), we will follow the right side of the Adult Cardiac Arrest algorithm.
Initial steps are aimed at delivery of high-quality CPR to keep the brain and vital organs alive.
Epinephrine administration.
Placement of an advanced airway.
Considering possible reversible H & T causes of cardiac arrest including three common causes of PEA and their emergent interventions.
When we should discontinue resuscitation efforts and call the code.
Connect with me:
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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Providing good, high-quality CPR with minimal interruptions and early defibrillation are two key interventions shown to improved cardiac arrest outcomes.
A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rate.
Characteristics of good songs that will help us.
Advantages & disadvantages of using a song during CPR.
Selected songs from various genres and time periods from AHA's "Don’t Drop The Beat" playlist on Spotify. https://open.spotify.com/playlist/2mU2FNAhSOtQwW0hBgQMaK
Connect with me:
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Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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A patient’s medical history will help us identify things that may be causing (or contributing) to their current condition as well as guide our decisions so we provide the safest evidence-based care possible.
Examples of information obtained in a medical history that will impact the treatment we provide.
There are several mnemonics and memory aids that people use to guide their history taking.
Review the SAMPLE-PQRST medical history format.
Connect with me:
Website: https://passacls.com
@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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Although magnesium can be used in the treatment of other medical conditions such as eclampsia, asthma, & digitalis toxicity; for ACLS, magnesium is primarily used to treat Torsades de Pointes.
Identification of Torsades on the ECG.
Administration of a magnesium infusion for stable patients vs slow IV push for patients in cardiac arrest.
Procainamide use for stable patients with a monomorphic wide-complex tachycardia.
Procainamide dosing and when to stop the infusion.
Tip for determining whether magnesium or Procainamide should be used when treating stable patients with V-Tach.
Connect with me:
Website: https://passacls.com
@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
Listen to Pass ACLS tips and other medical podcasts at ConveyMed.io
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When a patient loses excessive amounts of fluids, we say that they are in a state of hypovolemia.
The most obvious cause of hypovolemia is from bleeding.
Bleeding can be internal or external and caused by trauma, pathology, or iatrogenic.
Classic signs & symptoms of hypovolemic shock.
Volume replacement with crystalloids vs blood.
Connect with me:
Website: https://passacls.com
@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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MONA is the acronym sometimes used to help us remember the interventions to consider for patients with Acute Coronary Syndrome or ACS.
Morphine's use in the Acute Coronary Syndrome (ACS) algorithm.
Why Morphine is helpful for patients with ACS.
Contraindications and considerations for the safe administration of Morphine.
Morphine as an alternative to nitro for patients with chest pain that take PDE inhibitors.
Common dosing & administration of Morphine.
Monitoring of the patient's level of consciousness, pain, blood pressure, and respirations after administration.
Possible side effects of Morphine administration.
Narcan as an antidote to Morphine if needed.
Connect with me:
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@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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Even good CPR is far less efficient at circulating blood than a functioning heart.
The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include:
Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality.
Three tips to limit pauses in CPR compressions to 10 seconds or less.
Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.
Connect with me:
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@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
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Epinephrine and Dopamine are adrenergic agonist used in several ACLS algorithms.
The use of epinephrine for severe anaphylaxis and unstable bradycardia.
Review epinephrine’s effects on blood vessels and bronchioles.
Why epinephrine is helpful for patients with anaphylaxis.
Using an epi drip for unstable bradycardia.
Epinephrine administration during cardiac arrest.
Starting and epinephrine or Dopamine drip for patients that have ROSC.
Review the effects of Dopamine based on mcg/kg/min dosing.
Monitoring the patient and titrating epi or Dopamine drips to prevent harm.
For more information on ACLS medications, check out the pod resource page at passacls.com.
Connect with me:
Website: https://passacls.com
@Pass-ACLS-Podcast on LinkedIn
Give Back & Help Others:
Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Good luck with your ACLS class!
- Visa fler
