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ACLSStudyGuide
ExpressTrainingSolutions|www.ExpressTraining.com|888.815.0313
Pre-CourseSelf-AssessmentTheACLScoursenowhasamandatorypre-courseself-assessmentwithapassingscoreofatleast70%.Studentsmaytaketheself-assessmentasmanytimesasneeded.PleasebringyourassessmentresultswithyoutotheACLSclassoremailinadvancetoinfo@expresstraining.com.Instructionsforaccessingtheself-assessmentareincludedinyourregistrationconfirmation.
Pre-CourseVideosFollowthelinkinyourregistrationemailtoaccessthepre-courseself-assessment>enteraccesscodeACLS15&clicksubmit>DONOTclicklaunch…scrolldowntoaccessthevideosinstead.ACLSWrittenExamTheACLSProviderexamis50multiple-choicequestions,witharequiredpassingscoreis84%.AllAHAexamsarenow“openresource”whichmeansstudentmayusetheACLSmanual,studyguides,handoutsandpersonalnotesduringtheexam.UsingtheACLSProviderManualaheadoftimewiththeonlineresourcesisveryhelpful.BLSReview
AssessmentStepsforBLS1. Makesuresceneissafe2. Tap/shouttocheckforresponsiveness3. Callforhelpifpatientisunresponsive4. Checkforpulseandbreathingforatleast5butno
morethan10seconds5. Ifnopulse(ornotsureifthereisapulse)beginCPR
Compressions• Atleast2incheswitharatebetween100–120/min• Allowforfullrecoil• Lowerhalfofthebreastbone• PEtCO2(intubated)<10mmHgindicatespoorcompressions• Interruptionsincompressionsshouldbe<10seconds• Switchcompressorsevery2min.
BreathsDuringCPR• Ratioofcompressionstobreaths30:2• Eachbreathgivenover1second• Aneffectivebreathwillresultinvisiblechestrise• CPRwithETT:1breathevery6secondswith
continuouscompressions• VerifyETTplacementincode:waveformcapnography• Excessiveventilation=decreasedcardiacoutput
RescueBreathing• Forapatientwhoisnotbreathingorbreathingeffectively• Give1breathevery5-6seconds• Eachbreathgivenover1second• Aneffectivebreathwillresultinvisiblerise/fallofthechest• Excessiveventilationdecreasescardiacoutput• Difficultypositioningairwayforpatency,placeNPAorOPA• OPAPlacement=Measurefromthecornerofthemouthto
theangleofthemandibleACSandStroke
ACS-STEMI• Assessment:Pale,cool,diaphoretic,chestpain,
dyspnea,anxiety,hypotension,poorperfusion• Aspirin160-325mg• TimeframetostartCoronaryReperfusion<90min
Stroke• HeadCTwithin25min.(normalCTmayruleouthemorrhagic)• Tobetterfacilitatecare,notifyreceivinghospitalinadvance• IschemicStroke:startfibrinolytictherapyASAP• HemorrhagicStroke:neuroconsult
RRTandMET(RapidResponseTeam/MedicalEmergencyTeam)
• MET/RRTfocusesonpreventionofdeuteriationtocardiacarrest• Improvepatientcarebyidentifyingandtreatingearlyclinicaldeterioration
ACLSStudyGuide
ExpressTrainingSolutions|www.ExpressTraining.com|888.815.0313
EffectiveTeamDynamics1. Clearrolesandresponsibilities:Teamleadershouldclearlydelegatetasks2. Knowingyourlimitation:Stayinscopeofpractice/askforanewroleifinappropriatelyassigned3. Constructiveinterventions:ifsomeoneisabouttomakeamistakeaddressthatteammemberimmediately4. Knowledgesharing5. SummarizingandRe-evaluation6. Closedloopcommunication:Repeatbacktheorder7. Mutualrespect
BradycardiaandTachycardia
BradycardiawithaPulse• Ifsymptomatic,giveAtropine,0.5mgevery3-5min,
maxtotaldoseof3mg(6doses)• Ifstable,12-leadandgetexpertconsultation
TachycardiawithaPulse
• Ifunstable,immediatesynchronizedcardioversion• Ifstable,12-leadandexpertconsultation• Ifstablew/narrowQRS:
• Adenosine1stdose6mg/2nddose12mg
CardiacArrest(NoPulse)
AssessmentFindings• Unresponsive• Nopulse&nobreathing• Mayhaveagonalgasps
pVT/VF
• CPRfirstandwhiledefibischarging• 1mgepinephrineq3-5min(alwaysfirst
medyougivewhenthepatientisdead)• Amiodarone1stdose300mg/2nd150mg• Only2shockablerhythmsincardiacarrest
ASYSTOLE/PEA
• CPRfirst• Notshockable• 1mgepinephrineq3-5min• IfnopulseandnotpVT,VF,or
asystole,thenyouhavePEA
ManualDefibrillation• Immediatelyafteryoushockàcompressions• Immediatelyifnoshockindicatedàcompressions• Whilesettingupdefibrillationtoshockà
compressions• ContinueCPRwhilethedefibischarging
PostResuscitation/AfterROSC1. Optimizeventilationandoxygenation2. TreatHypotension,SBP<90mmHg3. IfSTEMIàCathLab4. Ifunabletofollowcommand:targetedtemperature
management• 32-36Catleast24hours
TachycardiaRhythmswithaPulse
Stable=goodBPandgoodmentation/Unstable=lowBPandpoormentation
SinusTachycardia
AtrialFibrillation
SupraventricularTachycardia
MonomorphicVentricularTachycardia
AtrialFlutter
PolymorphicVentricularTachycardia
ACLSStudyGuide
ExpressTrainingSolutions|www.ExpressTraining.com|888.815.0313
BradycardiaRhythmswithaPulse
Non-symptomatic=goodBPandgoodmentation/Symptomatic=lowBPandpoormentation
SinusBradycardia
2ndDegreeHeartBlock,Type2
1stDegreeHeartBlock
3rdDegreeHeartBlock
2ndDegreeHeartBlock,Type1
PulselessRhythms(CardiacArrest)
1stStartCPR|2ndShockpVT/VFImmediately|3rdEstablishIVAccess&giveEpi|4thTreatReversibleCauses(H/T)
PulselessVentricularTachycardia(Monomorphic) Asystole
PulselessVentricularTachycardia(Polymorphic)
PEA(PulselessElectricalActivity)
VentricularFibrillation
PEAisanyorganizedrhythmwithoutapulsethatisnotVForpVT