ACLS core cases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]

Synonyms and Keywords: ACLS cases; advanced cardiovascular life support cases; advanced cardiac life support cases

Overview

Advanced cardiac life support or (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.[1] Extensive medical knowledge and rigorous hands-on training and practice are required to master ACLS. Only qualified health care providers (e.g. physicians, paramedics, nurses, respiratory therapists and other specially trained health care providers) can provide ACLS, as it requires the ability to manage the patient's airway, initiate IV access, read and interpret electrocardiograms, and understand emergency pharmacology.

The advanced cardiac life support core cases

Acute Coronary Syndromes

Acute Stroke

Asystole

Bradycardia

Pulseless Electrical Activity

Respiratory Arrest

Stable Tachycardia

Unstable Tachycardia

Ventricular Fibrillation

Ventricular Fibrillation/Pulseless Ventricular Tachycardia

The Major Changes in Advanced Cardiovascular Life Support (ACLS) for 2010

  • Quantitative waveform capnography is recommended for confirmation and monitoring of endotracheal tube placement and CPR quality.[2]
  • The traditional cardiac arrest algorithm was simplified and an alternative conceptual design was created to emphasize the importance of high-quality CPR; hence the change from “A-B-C” to “C-A-B”
  • There is an increased emphasis on physiologic monitoring to optimize CPR quality and detect ROSC.
  • Atropine is no longer recommended for routine use in the management of pulseless electrical activity (PEA)/asystole.
  • Chronotropic drug infusions are recommended as an alternative to pacing in symptomatic and unstable bradycardia.
  • Adenosine is recommended as safe and potentially effective for both treatment and diagnosis in the initial management of undifferentiated regular monomorphic wide complex tachycardia.
  • Systematic post–cardiac arrest care after ROSC should continue in a critical care unit with expert multidisciplinary management and assessment of the neurologic and physiologic status of the patient. This often includes the use of therapeutic hypothermia.

References

  1. ACLS: Principles and Practice. p. 1. Dallas: American Heart Association, 2003. ISBN 0-87493-341-2.
  2. Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R; et al. (2010). "Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S640–56. doi:10.1161/CIRCULATIONAHA.110.970889. PMID 20956217.

External links

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