ACLS 2024 complete update A+ graded
Targeted temperature management - adults. 32 - 36 C (89.6 - 95.2F).
Titrate inspired O2 to... the lowest level required to achieve arterial O2 sat 94% + to avoid
complications associated with O2 toxicity.
Mean arterial pressure goal 65 mm Hg or greater
A team leader should be able to explain why it is essential to... push hard and fast in center
of chest.
ensure complete chest recoil.
minimize interruptions in compressions.
avoid excessive ventilation.
A team member should be... clear about role assignments.
prepared to fill their responsibilities.
well practiced in resuscitation.
knowledgeable about algorithms.
committed to success.
Resuscitation triangle (3) Compressor: assessed pt, 5 cycles chest compressions, alternates
with AED person every 5 cycles or 2 min.
AED/Defibrillator Monitor: brings and operates AED, places monitor where it can be seen by
team leader, alternates with compressor every 5 cycles or 2 min.
Airway: Opens airway, provides bag-mask ventilation, inserts airway adjuncts as appropriate.
Leadership roles (3) Team leader: every team needs one. assigns roles to team members, makes
treatment decisions, provides feedback, assumes responsibility for roles not assigned.
Meds: Initiates IV/IO access, administers meds.
,Time recorder: records time of interventions & medications and announces when next are due,
records frequency and duration of interruptions in compressions, communicates to the team
leader.
Should you start CPR when you are unsure about a pulse? Yes, unnecessary compressions are
less harmful than failing to provide compressions when needed.
Agonal gasps A sign of cardiac arrest!
May be present in first minutes.
Looks like pt is drawing in air quickly.
Occur at a slow rate.
May be forceful or weak.
Time passes between gasps.
Snort, snore, groan.
BLS assessment Check responsiveness.
Shout for help.
Get AED/send someone.
Look for breathing - chest 5-10 sec.
Check pulse at same time. 5-10 sec.
No pulse in 10 sec, start chest compressions.
If pulse, rescue breathing 1 breath q 5-6 sec. Check pulse q 2 minutes.
Defibrillation: check for shockable rhythm, shock, follow with compressions.
Minimize interruptions No longer than 10 sec!
Avoid...
prolonged rhythm analysis.
frequent/inappropriate pulse checks.
taking too long to give breaths.
unnecessary moving the pt.
Coronary Perfusion Pressure (CPP) Aortic relaxation (diastolic) - right atrial relaxation
(diastolic) pressure.
Correlates with both myocardial blood flow and return of spontaneous circulation.
ROSC does not occur unless it is 15 mm Hg or +
If < 20 improve chest compressions and vasopressor therapy.
Quality compressions compress 2 in (5 cm).
Rate 100-120 BPM.
Allow complete recoil.
single rescuer CPR Cardiac arrest: Call for help, get AED, return to pt, start CPR.
Hypoxia (drowning): give 2 mins CPR before activating emergency response system.
, Primary Assessment Assess before action!!!
Airway, Breathing, Circulation, Disability (Alert, Voice, Painful, Unresponsive), Exposure
(remove clothing to examine).
Secondary Assessment Focused medical history and physical exam.
SAMPLE
Signs and sx.
Allergies.
Medications (including last dose taken).
Past medical hx.
Last meal consumed.
Events.
H&Ts Common reversible causes of cardiac arrest.
Hypovolemia, hypoxia, hydrogen ion (acidosis), Hypo/hyperkalemia, hypothermia.
Tension pneumo, tamponade (cardiac), toxins, thrombosis (coronary or pulmonary).
2 most common causes of PEA Hypoxia and hypovolemia.
PEA hypovolemia rapid, narrow-complex tachycardia (sinus tachy).
Increased diastolic, decreased systolic pressure.
BP drops.
Narrow QRS.
Common causes: occult internal hemorrhage, severe dehydration.
Consider volume infusion.
acute coronary syndrome sudden symptoms of insufficient blood supply to the heart
indicating unstable angina or acute myocardial infarction
Tx for PE Fibrinolytics.
Tx for cardiac tamponade pericardiocentesis.
tx for Tension pneumo needle aspiration and chest tube placement.
Drug overdose/toxic exposure may lead to peripheral vascular dilation and/or myocardial
dysfunction with hypotension.
Tx: prolonged basic CPR, etracorporeal CPR, intra-aortic balloon pumping, renal dialysis, IV
lipid emulsion, digoxin, glucagon, bicarbonate, transcutaneous pacing, correction of electrolyte
imbalances.
Normal respiratory rate.
Normal tidal volume. 12-16/min.
Targeted temperature management - adults. 32 - 36 C (89.6 - 95.2F).
Titrate inspired O2 to... the lowest level required to achieve arterial O2 sat 94% + to avoid
complications associated with O2 toxicity.
Mean arterial pressure goal 65 mm Hg or greater
A team leader should be able to explain why it is essential to... push hard and fast in center
of chest.
ensure complete chest recoil.
minimize interruptions in compressions.
avoid excessive ventilation.
A team member should be... clear about role assignments.
prepared to fill their responsibilities.
well practiced in resuscitation.
knowledgeable about algorithms.
committed to success.
Resuscitation triangle (3) Compressor: assessed pt, 5 cycles chest compressions, alternates
with AED person every 5 cycles or 2 min.
AED/Defibrillator Monitor: brings and operates AED, places monitor where it can be seen by
team leader, alternates with compressor every 5 cycles or 2 min.
Airway: Opens airway, provides bag-mask ventilation, inserts airway adjuncts as appropriate.
Leadership roles (3) Team leader: every team needs one. assigns roles to team members, makes
treatment decisions, provides feedback, assumes responsibility for roles not assigned.
Meds: Initiates IV/IO access, administers meds.
,Time recorder: records time of interventions & medications and announces when next are due,
records frequency and duration of interruptions in compressions, communicates to the team
leader.
Should you start CPR when you are unsure about a pulse? Yes, unnecessary compressions are
less harmful than failing to provide compressions when needed.
Agonal gasps A sign of cardiac arrest!
May be present in first minutes.
Looks like pt is drawing in air quickly.
Occur at a slow rate.
May be forceful or weak.
Time passes between gasps.
Snort, snore, groan.
BLS assessment Check responsiveness.
Shout for help.
Get AED/send someone.
Look for breathing - chest 5-10 sec.
Check pulse at same time. 5-10 sec.
No pulse in 10 sec, start chest compressions.
If pulse, rescue breathing 1 breath q 5-6 sec. Check pulse q 2 minutes.
Defibrillation: check for shockable rhythm, shock, follow with compressions.
Minimize interruptions No longer than 10 sec!
Avoid...
prolonged rhythm analysis.
frequent/inappropriate pulse checks.
taking too long to give breaths.
unnecessary moving the pt.
Coronary Perfusion Pressure (CPP) Aortic relaxation (diastolic) - right atrial relaxation
(diastolic) pressure.
Correlates with both myocardial blood flow and return of spontaneous circulation.
ROSC does not occur unless it is 15 mm Hg or +
If < 20 improve chest compressions and vasopressor therapy.
Quality compressions compress 2 in (5 cm).
Rate 100-120 BPM.
Allow complete recoil.
single rescuer CPR Cardiac arrest: Call for help, get AED, return to pt, start CPR.
Hypoxia (drowning): give 2 mins CPR before activating emergency response system.
, Primary Assessment Assess before action!!!
Airway, Breathing, Circulation, Disability (Alert, Voice, Painful, Unresponsive), Exposure
(remove clothing to examine).
Secondary Assessment Focused medical history and physical exam.
SAMPLE
Signs and sx.
Allergies.
Medications (including last dose taken).
Past medical hx.
Last meal consumed.
Events.
H&Ts Common reversible causes of cardiac arrest.
Hypovolemia, hypoxia, hydrogen ion (acidosis), Hypo/hyperkalemia, hypothermia.
Tension pneumo, tamponade (cardiac), toxins, thrombosis (coronary or pulmonary).
2 most common causes of PEA Hypoxia and hypovolemia.
PEA hypovolemia rapid, narrow-complex tachycardia (sinus tachy).
Increased diastolic, decreased systolic pressure.
BP drops.
Narrow QRS.
Common causes: occult internal hemorrhage, severe dehydration.
Consider volume infusion.
acute coronary syndrome sudden symptoms of insufficient blood supply to the heart
indicating unstable angina or acute myocardial infarction
Tx for PE Fibrinolytics.
Tx for cardiac tamponade pericardiocentesis.
tx for Tension pneumo needle aspiration and chest tube placement.
Drug overdose/toxic exposure may lead to peripheral vascular dilation and/or myocardial
dysfunction with hypotension.
Tx: prolonged basic CPR, etracorporeal CPR, intra-aortic balloon pumping, renal dialysis, IV
lipid emulsion, digoxin, glucagon, bicarbonate, transcutaneous pacing, correction of electrolyte
imbalances.
Normal respiratory rate.
Normal tidal volume. 12-16/min.
