AHA ACLS Study Guide - University of Arizona
嚜澤HA ACLS Study Guide
ACLS Course Objectives
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Apply the BLS, Primary and Secondary Assessment sequences for a systematic evaluation of adult
patients.
Perform prompt, high quality BLS, including prioritizing early chest compressions and integrating early
AED use.
Recognize respiratory arrest and perform early management of respiratory arrest.
Discuss early recognition and management of acute coronary syndromes (ACS), including appropriate
disposition.
Discuss early recognition and management of stroke, including appropriate disposition.
Recognize bradyarrhythmias and tachyarrhythmias that may result in cardiac arrest or complicate
resuscitation outcome. Perform early management of bradyarrhythmias and tachyarrhythmias that may
result in cardiac arrest or complicate resuscitation outcome.
Recognize cardiac arrest and perform early management of cardiac arrest until termination of
resuscitation or transfer of care, including immediate post-cardiac arrest care.
Evaluate resuscitative efforts during a cardiac arrest through continuous assessment of CPR quality,
monitoring the patient＊s physiological response, delivering real-time feedback to the team.
Model effective communication as a member or leader of a high performance team & recognize the impact
of team dynamics on overall team performance.
Science of Resuscitation
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AHA ACLS book pg. 1
AHA ACLS book pg. 13
Immediate High Quality CPR starting with compressions at least 2 inches deep, 100-120/min
AED or Manual Defib ASAP 1 shock q 2 minutes for VF/pVT
Minimizing interruptions in compressions
Avoid excessive ventilations (decreases cardiac output and cerebral perfusion)
o 500-600 ML Tidal Volume
Coronary perfusion pressure > 15 and Chest Compression Fraction > 80%
ETCO2 ? 10 indicates compressions ineffective
Max 10 sec off chest at any time
Feedback devices recommended
Integrated post Cardiac Arrest Care
RRT/MET (Rapid Response Team and Medical Emergency Teams) improving outcomes by early
detection and early treatment
o Threatened airway
o Resp rate 30 per min
o Heart rate < 40 or > 140 per min
o Systolic pressure < 90
o Symptomatic Hypertension
o Unexpected ? LOC
o Unexplained agitation
o Seizure
o Significant decrease in urine output
o Subjective concern about pt.
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Update 01/2021
AHA ACLS Study Guide
Systematic Approach
AHA ACLS book pg. 33-42
Initial Impression 每 CBC (Consciousness 每 Breathing 每 Color)
? Unconscious 每 BLS survey - ? breathing and pulse, activate emergency response (call
code) High quality CPR, rapid defib
? Primary assessment ABCDE
o A 每 Airway patent, consider advanced device
o B 每 Breathing 2 breaths after 30 compressions
? If adv. Airway 1 breath q 6 sec.
? If has a pulse 每 1 breath q 6 sec rescue breathing
? If breathing 每 administer O2 as needed
o C 每 Support circulation, BP > 90 systolic or MAP 65
? Access 每 either IV or IO
? Drugs and fluids if indicated
? Temp and glucose levels
o D 每 Disability
? LOC 每 AVPU
? Alert
? Voice
? Painful
? Unresponsive
o E 每 Exposure
? Remove clothing 每 examine
? Secondary Assessment - SAMPLE
o S 每 Signs and symptoms
o A 每 Allergies
o M 每 Medications
o P 每 Past Medical history
o L 每 Last meal
o E 每 Events
? H and T§s
o Hypovolemia
o Hypoxia
o Hydrogen ion (acidosis)
o Hyperkalemia
o Hypokalemia
o Hypothermia
o Tension Pneumothorax
o Tamponade (Cardiac)
o Toxins
o Thrombosis
? Pulmonary
? Cardiac
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Update 01/2021
AHA ACLS Study Guide
HIGH Performance Teams
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AHA ACLS book pg. 25-32 Handbook pg. 8
Elements of Team Dynamics and communication
o Roles
? Clear roles and responsibilities 每 clearly delegate tasks
? Designated Team leader
? Know limitations 每 ask for new role if not assigned an appropriate task
? Constructive intervention
? Be tactful but address team member to prevent error
o What to communicate
? Knowledge sharing
? Summarizing and reevaluation
o How to communicate
? Closed-loop communication
? Clear messages
? Mutual respect
Debriefing
o Work together as a team
o Debriefing during and after code
? Improves team performance
o Improve patient outcome after arrest
? CPR Coach
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New role to promote delivery of high-quality CPR.
CPR Coaches stand across from compressor next to feedback-device.
Verbalizes feedback, mid-range target for HR
Coordinate CPR
o Initiating CPR, Placing CPR board, analyzing rhythm, switching compressors (goal to keep
pauses ................
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