Episoder
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Hypothermic patients aren't dead until they are warm and dead.
When a patient’s core body temperature drops below 96.8 F (36 C), they are hypothermic. As the body’s temperature drops below 36 C, hypothermia may further be classified as moderate or severe:
Moderate if the patient’s body core temp is between 30-34 C; andSevere if it's below 30 C.Modifying the ACLS Adult Cardiac Arrest algorithm for patients with severe hypothermia.
Following the ACLS algorithm for patients with a body core temperature above 30 C.
Methods for rewarming patients with moderate vs severe hypothermia.
Continuation of CPR and ACLS efforts until the patient’s body core temp is above 36 C.
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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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
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Good luck with your ACLS class!
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Calcium is one of the ions that move across the cellular membrane during cardiac contraction and relaxation.
The primary use of calcium channel blockers in ACLS is for the treatment of stable, narrow complex tachycardias refractory to Adenosine and to lower the blood pressure of ischemic stroke patients with severe hypertension.
Use of calcium channel blockers for SVT refractory to Adenosine and A-Fib or A-Flutter with RVR.
Contraindications of calcium channel blockers.
Nicardipine use during the treatment of ischemic strokes.
For more information on ACLS medications, tachycardia, or stroke check out the pod resource page at passacls.com.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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Mangler du episoder?
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The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.
Post-arrest care and recovery are the final two links in the chain of survival.
Identification of ROSC during CPR.
Initial patient management goals after identifying ROSC.
The patient’s GCS/LOC should be evaluated to determine if targeted temperature management (TTM) is indicated.
Patients that cannot obey simple commands should receive TTM for at least 24 hours.
Monitoring the patient’s core temperature during TTM.
Why we should cool unresponsive post-arrest patients.
Patients can undergo EEG, CT, MRI, & PCI while receiving TTM.
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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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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 home nitroglycerine.
Monitoring patient's pain and vital signs after nitro administration.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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 stable patients in A-Fib/Flutter with RVR.
For other medical podcasts that cover narrow complex tachycardias, visit the pod resource page at passacls.com.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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 Associated Emergency algorithm.
Other common ACLS Tablet Toxin scenarios with possible treatments.
Medications commonly used to treat specific toxins that are regularly stocked on crash carts or carried in EMS med bags.
ACLS providers that suspect a specific toxin should consult with their Pharmacy or call Poison Control for treatment directions.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
Poison Myths and Misconceptions on The Pharmacists Voice podcast:
https://www.thepharmacistsvoice.com/podcast/poison-myths-and-misconceptions-discussion-part-1-of-5-with-angel-bivens-rph-and-wendy-stephan-phd/
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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 need to repeat it.
3. We only do actions that are clinically appropriate and within our scope of practice.
Walk through of an example mega code scenario with explanations of when and why we change to a different ACLS algorithm.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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 instances for their use can be found on the Pod Resource page at PassACLS.com.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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 tube.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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 ACLS-related topics are on the Pod Resource page at PassACLS.com.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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, and considerations for use of Sodium Bicarbonate.
Treatment of alkalosis depends on the type (metabolic or respiratory) and is aimed at correcting the underlying cause.
Other podcasts that cover acid/base balance and conditions that cause acidosis or alkalosis can be found on the Pod Resource Page at PassACLS.com.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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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 will go down the left side of the Adult Cardiac Arrest Algorithm.
An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered.
We will follow the algorithm until the patient has ROSC or we 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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
Other Pass ACLS episodes mentioned
Objective Measures of Good CPR https://passacls.com/bls/objective-measures-of-good-cpr
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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.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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To pass ACLS, you will need to be able to identify common rhythms on a monitor during your mega code and ECG strips on your written exam.
If you don't normally monitor patients as part of your job, I suggest two things:
1. Find a system for ECG interpretation that works well for you; and
2. Practice reading ECGs every day for a few weeks before your class.
Review of normal ECG morphology of P wave, QRS complex, and T wave in lead II.
Characteristics of first degree heart block.
Characteristics of third degree (complete) AV block.
Treatment of unstable patients in third degree block following the ACLS Bradycardia algorithm.
Special considerations for use of Atropine when patients are in a third degree heart block.
The use of TCP, Dopamine, & Epinephrine drip for unstable bradycardic patients refractory to Atropine.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
Practice ECGs at Dialed Medics: https://dialedmedics.com/
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In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.
The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine.
Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.
Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach.
Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.
Amiodarone use & dosing for stable patients in V-Tach with a pulse.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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The tongue is the most common airway obstruction in an unconscious patient.
For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).
Examples of when a NPA should be considered.
Contraindications and considerations for nasal airway insertion.
Measuring a nasal airway for appropriate length and diameter.
Insertion of a nasopharyngeal airway into the right vs left nostril.
Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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When blood, or other fluids, accumulate in the sac around the heart it’s called a cardiac tamponade or pericardial tamponade.
The effects of tamponade on the electrical system and chambers of the heart.
Cardiac tamponade can be acute or chronic and caused by traumatic, iatrogenic, or pathological etiologies.
Common traumatic events, medical procedures, and diseases that can result in a pericardial tamponade.
Signs & symptoms of cardiac tamponade.
Treatment of cardiac tamponade with pericardiocentesis.
For additional information on cardiac tamponade, check out the Pod Resources page at PassACLS.com.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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Two things have changed in recent years to aid students that don't use ACLS in their daily practice.
1. The role of the team leader; and
2. The ability to use your quick reference cards.
The team leader is responsible for assigning tasks and overall direction of the team but can & should ask team members for help.
Using closed-loop communication to ensure the clarity of orders and speaking up if there’s any doubt about an order or action.
Use of your course’s approved text book and quick reference cards during the megacode and written exam.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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Two factors to cardiac arrest survivability that have been clearly shown to make the biggest difference is continuous, high-quality CPR and early defibrillation.
The most common dysrhythmia present during the first few minutes of cardiac arrest is ventricular fibrillation (VF).
The chance of successful defibrillation decreases every minute that passes.
How our chance of successfully defibrillating a patient into a perfusing rhythm significantly changes when good CPR is delivered vs when it isn't.
Why bystander CPR is important for out-of-hospital cardiac arrest (OHCA) outcomes.
The role of the CPR coach.
Five tips to aid us in limiting CPR interruptions to less than 10 seconds so we can maintain a chest compression fraction (CCF) of at least 80%.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
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Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.
We can use waveform capnography with, and without, an advanced airway in place.
Monitoring end tidal CO2 during rescue breathing.
Use of capnography to objectively measure good CPR.
Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code.
During CPR, a sudden increase in ETCO2 may indicate ROSC.
Quantitative waveform capnography use in the post-cardiac arrest algorithm.
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 made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.
Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.
Good luck with your ACLS class!
- Se mer
