Pass ACLS Tip of the Day

Patients with a narrow complex tachycardia with a rate over 150 BPM are in SVT. Unstable patients in SVT, or V-Tach with a pulse, should be cardioverted with a synchronized shock. Assessment & treatment of stable tachycardic patients. Commonly used vagal techniques. A less common technique to stimulate the vagus nerve is the dive reflex. Indications and use of Adenosine for stable patients in SVT refractory to vagal maneuvers. Possible treatments for patients found to be in A-Fib or A-Flutter with RVR after administration of Adenosine. Carotid sinus massage. Additional medical podcasts that have episodes on tachycardia can be found on the pod resources page at passacls.com. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Remembering all the different energy setting needed for synchronized cardioversion and defibrillation used to be confusing for a lot of people. Defibrillators can be broken down into three basic categories: Automated External Defibrillator (AED); Biphasic defibrillators; and Monophasic defibrillators. Because AEDs are designed to be used by first responders, and lay people with only minimal medical training, the controls are kept simple and are pre-programmed into the machine. Use of an AED to rapidly deliver a shock. Biphasic defibrillators automatically measure the impedance between the defib pads and will adjust the energy to deliver the shock needed based on the patient. Biphasic defibrillator use and energy setting. For older, monophasic defibrillators, use 360J to defibrillate V-Fib or pulseless V-Tach. AEDs must not be used on patients with a pulse. Cardioversion of patients in unstable SVT or V-Tach with a pulse using biphasic vs monophasic monitor/defibrillators. Team safety when performing synchronized cardioversion. Energy needed to cardiovert unstable patients with a narrow vs wide complex tachycardia. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Patients with a heart rate less than 60 are bradycardic. Some people can have a resting heart rate in the 40s without any compromise.  For others, a heart rate of 50 or less could signify the need for immediate intervention and warrants additional assessment. Signs & symptoms that indicate a bradycardic patient is unstable. Monitoring oxygen saturation with pulse oximetry and indications for administration of oxygen. Calcium channel blockers and beta blocker medication as treatable causes of bradycardia. The indications and dosage of Atropine. Precautions for Atropine use in patients with second or third degree AV blocks. The use of transcutaneous pacing (TCP) for unstable bradycardic patients refractory to Atropine. The use and dosing of Dopamine and Epinephrine drips. For additional information about causes and treatment of bradycardia, check out the pod resources page at PassACLS.com. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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. 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. Examples of in-hospital and out-of-hospital cardiac arrest (OHCA) outcomes when CPR is performed until defibrillation vs defibrillation without CPR. The role of the CPR coach. Three 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%. Feedback on the show, suggestions for episodes, and donations are appreciated. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

The chain of survival for ACLS is the same as was learned in your BLS class. The beginning steps of the Cardiac Emergency and Stroke chain of survival are the same. Recognizing the symptoms of a cardiac emergency or stroke; Activating an emergency response by calling 9-1-1, or a specialized code team if in the healthcare setting; Rapid assessment including 12 lead ECG for cardiac patients or FAST assessment for suspected stroke emergencies; Provide ALS care and transport to the most appropriate facility; for Early reperfusion. ACLS's timed goals for first medical contact to PCI for STEMI and door-to-needle for ischemic stroke. Areas with strong EMS relationships, well-defined transport protocols, and specialized teams that care for the patient in the hospital have significantly better patient outcomes. The cardiac arrest chain of survival adds: high quality CPR, early defibrillation, and advanced resuscitation as the next critical links followed by post arrest care and recovery. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes. When a patient's potassium levels get too low or too high hypokalemia or hyperkalemia results respectively. Two things that may lead us to suspect hypo or hyperkalemia include the patient's medical history and changes to the T wave on the ECG. Medical conditions that cause potassium imbalance. ECG changes seen in hypo and hyperkalemia. Critical lab values that would indicate a need for treatment. Emergent, ACLS interventions for hypokalemia and hyperkalemia. Additional information on hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

When treating patients having an MI or stroke, more minutes equals more dead cells. Because the majority of strokes are the ischemic type, the treatment for stroke is similar to an MI – to reestablish perfusion to the ischemic tissues.  Review the first four steps in the Stroke Chain of Survival. Time criteria for the administration of tPA or EVT of LVO strokes. Stroke benchmarks for door to: assessment; starting a non-contrast CT; and administration of tPA (door-to-needle). EMS interaction with stroke teams and destination protocols to reduce time to definitive care. Remember that timed goals for cardiac patients start with point of first medical contact while stroke benchmarks start at arrival to the hospital. Additional information about timed goals for stroke and how EMS affects outcomes can be found on the PassACLS.com pod resources page. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Adenosine is the first IV medication given to stable patients with sustained supraventricular tachycardia (SVT) refractory to vagal maneuvers. Common causes of tachycardia. Symptoms indicating a stable vs unstable patient. Cardiac effects of Adenosine. Indications for the use of Adenosine in the ACLS Tachycardia algorithm. Considerations and contraindications for Adenosine use. Adenosine as a diagnostic for patients in A-Fib or A-Flutter with RVR. Dosing and administration of Adenosine. Other podcasts that cover common ACLS antiarrhythmics in detail. **American Cancer Society (ACS) Fundraiser This is the fourth year that I'm participating in Real Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission. I hope you'll consider contributing. Every donation makes a difference in the fight against breast cancer! http://main.acsevents.org/goto/paultaylor (Paul Taylor's ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block. One method of ECG rhythm identification is to ask a series of questions such as: What's the rate (150); Is the rhythm regular or irregular; What's the shape and frequency of P waves and QRS complexes; and What's the P-R interval and is it constant? ECG characteristics of a second-degree Mobitz type I (Wenckebach). Identification of unstable bradycardia and it's treatment with Atropine. ECG characteristics of a second-degree Mobitz type II. Possible effect of using Atropine on patients with a second-degree type II AV block. Treatment of unstable patients refractory to Atropine using TCP, Dopamine, or Epinephrine drip. Starting dose and titration of Dopamine and Epinephrine drips. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

When treating patients with Acute Coronary Syndrome (ACS), MONA is an acronym sometimes used to help us remember the initial interventions. The O in MONA is Oxygen. When should we administer oxygen to ACS patients. When is O2 administration unnecessary. Monitoring patient's oxygen saturation (SaO2) using a pulse oximeter. Review two common ACLS mega code scenarios. Oxygen administration during CPR and post cardiac arrest. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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 (ROSC); 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 return of spontaneous circulation (ROSC). Quantitative waveform capnography is used post-cardiac arrest to aid us in maintaining an ETCO2 of 35-45 mm Hg. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Along with early defibrillation, high-quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes. How do we know if high-quality, effective CPR is being performed? The CPR coach as a new position of the code team. Objective measures of high-quality CPR include: Compression rate of 100-120 per minute; Compression depth of at least 5 cm; Allowing for full chest recoil; Maintaining an ETCO2 of at least 10 mm Hg; and Keeping interruptions to less than 10 seconds to obtain a chest compression fraction (CCF) of 80%. The advantages and use of real-time feedback devices to monitor the rate, depth, and chest recoil of CPR compressions. The use of end tidal waveform capnography. A no tech way to monitor effective CPR if no feedback devices are available. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

The 2020 ACLS guidelines updated the dose for administration of Atropine and Dopamine for the treatment of unstable bradycardia. The signs & symptoms of unstable bradycardia. Atropine's new dose and maximum. The use of atropine when a patient is in a second degree type II or third degree heart block. ECG changes that indicate subsequent doses of atropine are likely to be ineffective. The 2020 update to the starting dose of Dopamine. The use of Dopamine for bradycardia as an interim until TCP vs hypotension. The use of Atropine and Dopamine in patients with myocardial ischemia. Podcasts with additional (advanced-provider level) information about Atropine, Dopamine, and bradycardia can be found on the Pass ACLS pod resources page. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

The tongue is the most common airway obstruction in an unconscious patient. Insertion an oropharyngeal airway helps keep the patient's tongue from falling to the back of the pharynx and causing an airway obstruction. The oropharyngeal airway is sometimes called an OPA or simply an oral airway. Indications for using an oral airway. Contraindication for an oral airway and an alternative that can be used instead. Measuring an OPA and possible complications from inserting one that's too small or too large. Two techniques to properly insert an OPA and avoid complications. The use of an oral airway during CPR. The use of an OPA as a bite block after a patient has an advanced airway placed. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Hypoxia is a state of low oxygen levels in the blood.  Determining hypoxia using a pulse oximeter or arterial blood gasses (ABGs). A goal of ACLS is to recognize signs of hypoxia and provide timely treatment to prevent an arrest. Examples of some things that might lead us to think of hypoxia as a cause of cardiac arrest. Why we should not rely on pulse ox to give accurate readings during CPR. Delivering ventilations with near 100% oxygen concentration using a BVM attached to supplemental O2 and a reservoir. Using end tidal waveform capnography to assess the quality of CPR. Changes to ventilation rates, tidal volume, and O2 concentration affects a patient's oxygen, carbon dioxide, and pH. The danger of over ventilating a patient in cardiac arrest. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

ECG characteristics of supraventricular tachycardia (SVT) vs. sinus tachycardia. Signs & symptoms that indicate a patient is unstable. Treatment of unstable SVT using a biphasic vs monophasic defibrillator. Consideration for team safety while performing synchronized cardioversion. Treatment of stable patients in SVT. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

When working to resuscitate a patient in sudden cardiac arrest, Epinephrine is the first IV medication we administer.   When do we give the first dose of epinephrine for patient is in shockable vs non-shockable rhythm. When to give the first dose of epinephrine and its frequency for patients in asystole or PEA following the right side of the Adult Cardiac Arrest algorithm. When to give the first dose of epi and its frequency for patients in V-Fib or pulseless V-Tach following the left side of the Adult Cardiac Arrest algorithm. Example chronology of events for a scenario where a patient is found unresponsive, pulseless, and only gasping/agonal breathing. Administration of epi via the IO or endotracheal route in the absence of a patent IV. The maximum cumulative dose of epinephrine that can be administered to patients in cardiac arrest. When do we stop administering epinephrine. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

If a patient fails one of the FAST tests in the Cincinnati Prehospital Stroke Scale, there's a 72% chance they're having a stroke. We should assume a stroke unless we identify another condition that could be causing the symptoms. There are several medical conditions that can mimic a stroke. Some are easy to identify with point-of-care testing while others require labs, imaging, or other specialized tests. Identifying and treating hypoglycemia, hyperglycemia, hypoxia, and seizures with simple testing and reviewing the patient's medical history. Electrolyte imbalance, sepsis, brain tumors, and Bell's Palsy require labs, imaging, and specialized testing to diagnose and treat. Using EMS destination protocols or hospital rapid response teams to quickly identify and treat suspected stroke patients. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Most ACLS medications are given IV push. But, what happens if we can't get an IV? When IV access isn't available, we should consider administering our IV medications via intraosseous (IO)or endotracheal tube (ETT) route. Why IO is better for than ETT as an alternative route. The locations we should place an IO when running a code and a location we should avoid. The ACLS medications that can be given intraosseous. Where you can find more information about intraosseous access during resuscitation efforts. In the absence of an IV or IO, some medications may be given down the endotracheal tube. The disadvantages of medication administration via ETT. Review of the medications that can be given down the tube and how they should be given. Medications should not be given down the tube when anything other than an endotracheal tube is used as an advanced airway. Not ACLS but something I'm just as passionate about is the battle against cancer. This is the fourth year that I'm participating in Real Men Wear Pink and have pledged to wear pink every day in October to: raise awareness of breast cancer; connect with breast cancer patients & survivors; and raise money for the American Cancer Society's life-saving mission. Chances are that you know someone that has fought breast cancer or have lost a loved one to this insidious disease. Please consider making a donation to my American Cancer Society fundraiser and make a difference in the fight against breast cancer. Donations go directly to the American Cancer Society and can be made anonymously to protect your privacy. http://main.acsevents.org/goto/paultaylor (Paul Taylor's Real Men Wear Pink ACS Fundraiser) THANK YOU! Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

The chain of survival for a cardiac emergency and stroke start the same: preparedness & recognition of an emergency; activation of EMS; delivery of Advanced Life Support; and transporting to the most appropriate facility. Depending on where you live, Emergency Medical Services (EMS) may provide prehospital Advanced Life Support (ALS). ALS ambulances are staffed with paramedics who have training in ACLS skills. Paramedics can perform an assessment, obtain a medical history, and provide life-saving care within minutes of recognition. Why EMS "Destination Protocols" for suspected stroke and STEMI make a difference. Review ACLS timed benchmarks for: point of first medical contact to PCI for ST elevation MI; door to CT for suspected stroke; door to tPA for ischemic stroke; and onset of symptoms to EVT for LVO strokes. EMS may bypass a close hospital to transport a STEMI or suspected stroke patient to a more appropriate hospital - one capable of 24/7 PCI or a certified stroke center; because time is heart muscle or brain cells. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Performing good CPR, and delivering a shock as soon as possible to a patient in Ventricular  Fibrillation or pulseless V-Tach are the two most critical interventions that have been shown to increase survival from sudden cardiac arrest. To aid in the rapid delivery of a shock, an Automated External Defibrillator (AED) should be used in settings where a full monitor/defibrillator isn't available. Research has demonstrated significantly better out of hospital cardiac arrest survival outcomes in communities with robust public CPR training and public access/first responder AEDs. Why an AED makes a difference. The general use of AED including: indications for use; attaching the AED pads; following verbal prompts; and safely administering a shock. Following the Adult Cardiac Arrest algorithm while using an AED. Contraindications to AED use. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

For apneic patients without a carotid pulse or pulseless patients with only gasping/agonal respirations, we will follow the Adult Cardiac Arrest algorithm. For pulseless patients that the AED doesn't advise a shock, the patient's ECG shows asystole, or a non-perfusing organized rhythm (PEA), we will follow the right side of the algorithm. Initial steps are aimed at delivery of high quality CPR to keep the brain and vital organs alive. Epinephrine administration. Placement of an advanced airway. Considering possible reversible H & T causes of cardiac arrest including three common causes of PEA and their emergent interventions. When we should discontinue resuscitation efforts and call the code. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Providing good, high quality, CPR with minimal interruptions and early defibrillation are two keys to improved cardiac arrest outcomes. A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rate. Characteristics of good songs that will help us. Advantages & disadvantages of using a song during CPR. Selected songs from various genres and time periods from AHA's "Be The Beat" playlist on Spotify. https://open.spotify.com/playlist/2mU2FNAhSOtQwW0hBgQMaK (https://open.spotify.com/playlist/2mU2FNAhSOtQwW0hBgQMaK) Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

A patient's medical history will help us identify things that may be causing (or contributing) to their current condition as well as guide our decisions so we provide the safest evidence-based care possible. Examples of information obtained in a medical history that will impact the treatment we provide. E.g. Not giving nitro to patients taking PDE inhibitors. There are several mnemonics and memory aids that people use to guide their history taking. Review of the SAMPLE PQRST medical history. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Although magnesium can be used in the treatment of other medical conditions such as eclampsia, asthma, & digitalis toxicity; for ACLS, magnesium is primarily used to treat Torsades de Pointes. Identification of torsades on the ECG. Administration of a magnesium infusion for stable patients vs slow IV push for patients in cardiac arrest. Procainamide use for stable patients with a monomorphic wide-complex tachycardia. Procainamide dosing and when to stop the infusion. Tip for determining whether magnesium or Procainamide should be used when treating stable patients with V-Tach. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

When a patient loses excessive amounts of fluids, they are in a state of hypovolemia. Bleeding is not the only cause of fluid loss that can lead to low fluid volume. Bleeding may be internal or external and have traumatic, pathogenic, or iatrogenic etiology. Other common conditions that can lead to hypovolemia. Review the signs & symptoms of hypovolemic shock that may be present before cardiac arrest and lead us to suspect hypovolemia as a cause. Treatment of hypovolemia with administration of crystalloid IV solutions or blood. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Morphine is a relatively safe medication used in the ACS algorithm. Morphine should be considered for patients with severe ischemic chest pain that is unresolved after the safe administration of aspirin, oxygen, and nitroglycerine. Why its analgesic and vasodilation effects are helpful for patients with ischemic chest pain. Morphine use for ACS patients patients taking PDE inhibitors. Dosing, administration, and monitoring of patients. Reversal of Morphine's untoward effects with Narcan. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Studies in the early 2010's correlated CPR compressions to coronary perfusion pressures and improved outcomes as measured by Return of Spontaneous Circulation (ROSC) and survival to discharge. Minimizing interruptions to chest compressions so that we can maintain a chest compression fraction of at least 80% is the first indicator of high-quality CPR that was identified at the 2012 AHA CPR Quality Summit. We should use end tidal CO2 waveform capnography and other real-time feedback devices to monitor the effectiveness of CPR compressions and ventilations. Ideally, we should limit pauses to chest compressions as much as possible and resume compressions within 10 seconds. To do this we should: Limit pauses during defibrillation; Don't stop compressions while inserting an advanced airway; and Perform activities that require a pause at the same time. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Epinephrine is the most commonly used medication in ACLS.  Epi is used to treat certain conditions to prevent cardiac arrest, during a cardiac arrest, and post arrest. Epinephrine's use for treatment of anaphylaxis and unstable bradycardia. Administration of epi in the Adult Cardiac Arrest algorithm. Use of Epinephrine or Dopamine drip for hypotension post cardiac arrest. Review the dose-dependent effects of Dopamine. Use of Dopamine for unstable bradycardia.

Providing rescue breathing to apneic patients with a palpable pulse. Normal end tidal CO2 for patients with a pulse. Identification of cardiac arrest and our immediate actions. Providing artificial ventilations during CPR without an advanced airway vs with an advanced airway in place. Using quantitative waveform capnography to confirm placement of an advanced airway, assess the quality of CPR, and identify ROSC. The effects of hyperventilating patients in cardiac arrest. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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; and Severe if it's below 30 C. Why hypothermic patients aren't dead until they are warm and dead. 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. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Calcium is one of the ions that move across the cellular membrane during cardiac contraction and relaxation. For ACLS, the primary use of calcium channel blockers is for the treatment of stable, narrow complex tachycardias refractory to vagal maneuvers and Adenosine. Nicardipine may also be used 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's use during the treatment of ischemic strokes. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

While running a code, the thing we hope for is Return of Spontaneous Circulation (ROSC), followed by recovery so the patient can return to a normal life.  The actions we take after identifying ROSC has a significant impact on a patient's eventual outcome.  The Post-Cardiac Arrest Care algorithm provides us with evidence-based guidance for the initial stabilization phase as well as continued management activities. Our primary focus immediately following ROSC is aimed at ensuring adequate perfusion of the body's vital organs. Management of O2 and CO2 concentrations. Administration of Atropine for symptomatic bradycardia. Maintaining a systolic BP of at least 90 and MAP of 65 mm Hg or more. Use of Dopamine, Levophed, and Epinephrine drips. Starting targeted temperature management (TTM) for 24 hours based on the patient's level of consciousness. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Nitroglycerine is one of the front-line medications used in the Acute Coronary Syndrome (ACS) algorithm. Nitro's effect on peripheral blood vessels and coronary arteries. Indications for use of nitroglycerine. Contraindications and when it should be used with caution. Nitroglycerine dosage & administration. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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). Team safety when cardioverting a patient in A-FIB with RVR. Treatment of stable patients in A-Fib/Flutter with RVR. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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 include:  tricyclic antidepressants, digoxin; beta blockers; calcium channel blockers; cocaine; organophosphates; and benzodiazepines. Medications commonly used to treat specific toxins that are regularly stocked on crash carts or carried in EMS med bags include: sodium bicarb, calcium chloride, magnesium sulfate, benzodiazepines, atropine, and glucagon. ACLS providers that suspect a specific toxin should consult with their Pharmacy or call Poison Control for treatment directions. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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: If a patient's condition changes, we should do an assessment and use the algorithm that matches the patient's current state. If an action was already done, we don't need to repeat it. 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: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Beta blocking medications attach to Beta receptors to inhibit or “block” the effects of epinephrine and norepinephrine in the body. Review the primary locations of Beta I, II, and III receptors. Epinephrine & norepinephrine stimulation of beta I receptors in the heart results in an increase of the heart's rate and force of contractions; increasing the workload of the heart. Beta blockers affects 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. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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. After we have assessed and addressed O2 saturation, ETCO2, and BP, we may consider the use of an antiarrhythmic infusion if the patient has ventricular ectopy on the ECG. Determining which antiarrhythmic to use depends on what medications were given before the patient converted. The use of Amiodarone for ventricular ectopy post arrest if no antiarrhythmics were administered prior to obtaining ROSC. The indications, dose, and administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.

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 serum pH is 7.35-7.45. Using ABGs 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. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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 attaching the AED or defib pads as soon as it arrives at the patient's side. If the patient is in a non-shockable rhythm on the ECG such as PEA or systole, 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 where 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: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

For patients exhibiting symptoms consistent with myocardial ischemia, Aspirin is one of 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 use. The dose and route of administration of aspirin for ACS patients. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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: Find a system for ECG interpretation that works well for you; and 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. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

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. For patients that have return of spontaneous circulation (ROSC) and have ventricular ectopy on the ECG after we've ensured adequate oxygenation, an antiarrhythmic drip may be indicated. Review drip rates for Amiodarone and Lidocaine infusion post cardiac arrest to suppress ventricular ectopy. Amiodarone dosing and use for stable patients in V-Tach with a pulse refractory to vagal maneuvers. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!