ACLS Overview

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ACLS Overview

• Elizabeth Blanchard Jones, MD

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What is ACLS?

• A uniform method for resuscitation
• Adults
• Non-traumatic
• Cardiac or respiratory arrest
• Based on a comprehensive review of resuscitation
  research
• Last update Dec 2005

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Why do I need to take ACLS?

• All physicians need to be able to provide care
  for the first 5 minutes of cardiac arrest.
• AHA encourages even non-HCPs to have this
  training.
• In an emergency patients expect all doctors to be
  able to help.
• May be useful for friends, family or in your
  office.
• Required by most hospitals for all residents.

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Advantages of ACLS

• Based on the science
• A uniform approach for disparate resuscitation
  providers
• Provides a script in a stressful situation
• Lets you practice skills and scenarios in a calm
  environment

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Course content

• Day 1 amlecture
• Day 1 pmskills stations and CPR review
• Day 2 amskills stations
• Day 2 pmtesting stations

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Student requirements

• Complete pre-test
• Be on time
• Sign in sheets for each ½ day
• Pay attention in skills stations
• Ask questions if you dont understand
• Study the algorhythms
• Pass the test

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Testing

• Written
• Airway management
• mega-code

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Written test

• 84 is passing
• With 25 questions you can only miss 4
• You may not use any books or notes.
• If you fail, we will discuss the missed questions
  with you and you will then take another test.

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Airway

• Physicians must intubate the mannequin within 3
  attempts.
• You will practice intubation this afternoon and
  tomorrow morning.
• You may also practice at lunch.
• You will also be asked to demonstrate
  non-invasive airway management.

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Mega-code

• Perform a code scenario
• Always includes ventricular fibrillation
• You may use the ECC Handbook or the algorhythms
  to look up drug doses
• You should know the first few minutes of the
  arrest scenario well
• If you fail, you will be told to study certain
  areas and the will take the megacode again

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How late will we be here Friday?

• We cant push anyone through in front of others.
• Most people will be out by 4p easily, some
  earlier
• The best way to finish quickly is to know your
  ACLS

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Principles of ACLS

• ABCs
• Stable or unstable
• Electricity or drugs
• Post-resuscitation care

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ABCs

• Airway
• Breathing
• Circulation
• If an abnormality is found, fix it before moving
  to the next letter.
• E.g. Airway is obstructed, open it, then check
  breathing

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After the ABCs

• Disability
• Exposure
• Then secondary survey as you are resuscitating
  the patient

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Stable or unstable?

• With any cardiac rhythm, first decide if the
  patient is stable or unstable
• If unstable, decide if the rhythm is causing the
  unstable symptoms
• For example, patient with asthma attack with
  sinus tach at 125
• Or, patient with BP of 78/30 and ventricular
  tachycardia at 160

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Stable

• Alert
• BP normal for that patient or high
• In no distress
• No chest pain
• No difficulty breathing

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Unstable

• Altered mentation
• Hypotensive
• Chest pain
• Difficulty breathing

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Electricity or Drugs

• For unstable tachycardiasshock patient
• For unstable bradycardiasplace pacemaker
• For all stable rhythms--medications

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Post-resuscitation care

• What can I do to prevent the patient from coding
  again?
• What caused the arrest?
• What treatment does this condition need?

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Questions?