
Advanced Cardiovascular Life Support
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17.10 лв.
Етикети: Advanced Cardiovascular Life Support, advancedcardiovascularlifesupport, Ксерокопия
Part 1
Introduction
Course Description and Goal 1
Course Objectives 1
Course Design 2
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BLS Skills 3
ECG Rhythm Interpretation for Core ACLS Rhythms 3
Basic ACLS Drug and Pharmacology Knowledge 3
Course Materials 4
ACLS Provider Manual , 4
Student Website 5
Pocket Reference Cards 7
Precourse Preparation Checklist 7
Requirements for Successful Course Completion 7
ACLS Provider Manual Abbreviations 8
Advanced Cardiovascular Life Support 10
Closing the Gaps 11
Quality Assessment, Review, and Translational Science 11
Part 2
Systems of Care 13
Introduction 13
Cardiopulmonary Resuscitation 13
Quality Improvement in Resuscitation Systems, Processes and Outcomes 13 A Systems Approach 13
Measurement _ 16
Benchmarking and Feedback 17
Part 2
Systems of Care 13
Introduction 13
Cardiopulmonary Resuscitation 13
Quality Improvement in Resuscitation Systems, Processes and Outcomes 13 A Systems Approach 13
Measurement _ 16
Benchmarking and Feedback 17
Summary 17
Acute Coronary Syndromes 17
Starts “On the Phone!: With Activation of EM° 1'
EMS Components
Hospital-Based Components 13
Post-Cardiac Arrest Care 19
Targeted Temperature Management 19
Hemodynamic and Ventilation Optimization 19
Immediate Coronary Reperfusion With PCI 20
Glycemic Control 20
Neurologic Care and Prognostication 20
Education, Implementation, and Teams 20
The Need for Teams 20
Cardiac Arrest Teams (In-Hospital) 20
Rapid Response System 21
Published Studies 22
Implementation of a Rapid Response System 22
Part 3
Effective High-Performance Team Dynamics 25
Introduction 25
Roles of the Leader and Members of a High-Performance Team 25
Role of the Team Leader 25
Role of the Team Member 26
Elements of Effective High-Performance Team Dynamics 26
Roles 26
What to Communicate 29
How to Communicate 31
Part 4
The Systematic Approach 33
Introduction 33
The Systematic Approach 33
Cverview of the Systematic Approach 33
The BLS Assessment 34
Overview' of the BLS Assessment 35
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Overview o* the Primari Assessment 33
The Secondary Assessment 40
Overview of the Secondary Assessment 40
H s and T'p 40
Diagnosing and Treating Underlying Causes 41
Introduction 41
Conditions and Management 41
Hypovolemia 41
Cardiac and Pulmonary Conditions 41
Drug Overdoses or Toxic Exposures 42
Parts
The ACLS Cases 43
Overview of the Cases 43
Respiratory Arrest Case 44
Introduction 44
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Normal and Abnormal Breathing 44
Identification of Respiratory Problems by Severity 44
Respiratory Distress 44
Respiratory Failure 45
Respiratory Arrest . 45
The BLS Assessment 46
Assess and Reassess the Patient 46
Ventilation and Pulse Check 46
The Primary Assessment 46
Airway Management in Respiratory Arrest 46
Ventilations 46
Management of Respiratory Arrest 47
Overview 47
Giving Supplementary Oxygen 47
Maintain Oxygen Saturation 47
Opening the Airway 47
Common Cause of Airway Obstruction 47
Basic Airway Opening Techniques 47
Airway Management 48
Providing Basic Veniiiation 49
Basic Airway Skills 49
Bag-Mask Ventilation 49
Basic Airway Adjuncts: Oropharyngeal Airway 5*
introduction 5',
Technique of OPA Insertion 51
Basic Airway Adjuncts: Nasopharyngeal Airway 55
Technique of NPA Insertion
Suctioning 55
Introduction 55
Soft vs Rigid Catheters 55
Oropharyngeal Suctioning Procedure 56
Endotracheal Tube Suctioning Procedure 56
Providing Ventilation With an Advanced Airway 56
Introduction 56
Ventilation Rates 57
Laryngeal Mask Airway 57
Laryngeal Tube 57
Esophageal-Tracheal Tube 57
tnaotracheal lube 5«
Precautions for Trauma Patients 58
Summary 58
Acute Coronary Syndromes Case 59
Introduction f 59
Rhythms for ACS 59
Drugs for ACS 59
Goals for ACS Patients 60
Pathophysiology of ACS 60
Managing ACS: The Acute Coronary Syndromes Algorithm 62
Overview of the Algorithm 62
Important Considerations 63
Application of the ACS Algorithm 63
Identification of Chest Discomfort Suggestive of Ischemia 63
Signs and Conditions 63
Starting With Dispatch 64
EMS Assessment, Care, and Hospital Preparation 64
Introduction 64
Monitor and Support ABCs 64
Administer Oxygen and Drugs 65
Obtain a 12-Lead EGG 67
immediate ED Assessment and Treatment 67
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Patient General Treatment 68
Classify Patients According to ST-Segment Deviation $S
Classify Into ? Groups Baser on ST Seciment Deviation ad
STEM! 69
Introduction 69
Early Reperfusion Therapy 70
Use of PCI 70
Use of Fibrinolytic Therapy 71
Adjunctive Treatments 71
Acute Stroke Case 73
Introduction 73
Potential Arrhythmias With Stroke 73
Drugs for Stroke 73
Approach to Stroke Care 74
Introduction 74
Goals of Stroke Care 75
Critical Time Periods 76
Application of the Suspected Stroke Algorithm 78
Identification of Signs of Possible Stroke 78
Warning Signs and Symptoms 78
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Activate EMS System Immediately 78
Stroke Assessment Tools 78
Critical EMS Assessments and Actions 81
Introduction 81
Critical EMS Assessments and Actions 81
In-Hospital, Immediate General Assessment and Stabilization 82
Introduction 82
Immediate General Assessment and Stabilization 82
Immediate Neurologic Assessment by Stroke Team or Designee 83
Overview 83
Establish Symptom Onset 83
Neurologic Examination 84
CT Scan: Hemorrhage or No Hemorrhage 84
Introduction 84
Decision Point: Hemorrhage ot No Hemorrhage 8^
Fibrinolytic Therapy 86
introduction 86
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Potentia1 Adverse Effect? 87
Panie:a is a candidate for Fibrinolytic Therapy -jo
Extended IV rtPA Window 3 to 4.5 Hours SS
Intra-arterial rtPA 88
Endovascular Therapy 89
Introduction 89
Intra-arterial rtPA 89
Mechanical Clot Disruption/Stent Retrievers 89
Systems of Care 89
General Stroke Care
Introduction
Begin Stroke Pathway
Monitor Blood Glucose
Monitor for Complications of Stroke and Fibrinolytic Therapy Hypertension Management in rtPA Candidates
Cardiac Arrest: VF/Pulseless VT Case
Introduction
Measurement
Benchmarking and Feedback Change
Rhythms for VF/Pulseless VT Drugs for VF/Pulseless VT
Managing VF/Pulseless VT: The Adult Cardiac Arrest Algorithm
Overview VF/pVT (Left Side)
Asystole/PEA (Right Side)
Summary
Application of the Adult Cardiac Arrest Algorithm: VF/pVT Pathway
Introduction
Minimal Interruption of Chest Compressions
Deliver 1 Shock
Purpose of Defibrillation
Principle of Early Defibrillation
Resume CPR
Rhythm Check
Self-Adhesive Pads
Shock and Vasopressors
Rhythm Check
Shock and Antiarrhythmics
Cardiac: Arresi Treatmen. Sequences
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Treatment os VF/oVT in Hypothermia
Routes of Access for Drugs 7 04
Priorities ! 04
intravenous Route (04
intraosseous Route 105
Endotracheal Route Fluid Administration
Vasopressors 105
Introduction 105
Vasopressors Used During Cardiac Arrest 106
Epinephrine 106
Antiarrhythmic Agents 106
Introduction 106
Amiodarone 106
Lidocaine 106
Magnesium Sulfate 107
Steroids in Cardiac Arrest 107
Respiratory or Cardiac Arrest Associated With Opioid Overdose 10/
Extracorporeal CPR (for VF/Pulseless VTIAsystoleIPEA) 109
Extracorporeal Membrane Oxygenation 109
Ultrasound (for VF/Pulseless VT/Asystole/PEA) 109
Ultrasound Use in Cardiap Arrest 109
Cardiac Arrest: Pulseless Electrical Activity Case 110
Introduction 110
Rhythms for PEA 110
Drugs for PEA 110
Description of PEA 110
Introduction 110
Historical Perspective 110
Managing PEA: The Adult Cardiac Arrest Algorithm 111
Overview 111
The PEA Pathway of the Cardiac Arrest Algorithm 111
Decision Point: Rhythm Check 111
Administer Epinephrine 111
Nonshockable Rhythm 111
Decision Point: Shockable Rhythm 113
Asystole and PEA Treatment Sequences 113
Identification and Correction of Underlying Cause 113
Cardiac Arrest Asystole Case 114
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Rhvthms for Asystole 114
Drugs for Asysxoie
Approach to Asystole 114
introauciion 114
Patients With DNAR Orders Asystole as an End Point
Managing Asystole 115
Overview 115
Adult Cardiac Arrest Algorithm 115
Identification and Correction of Underlying Cause 116
Application of the Adult Cardiac Arrest Algorithm: Asystole Pathway 116
Introduction 116
Confirmed Asystole 116
Administer Epinephrine 116
Decision Point: Rhythm Check 116
Nonshockable Rhythm 116
Shockable Rhythm 116
Asystole and PEA Treatment Sequences 116
TCP Not Recommended 117
Routine Shock Administration Not Recommended 117
When in Doubt 117
Terminating Resuscitative Efforts 117
Terminating In-Hospital Resuscitative Efforts 117
Terminating Out-of-Hospital Resuscitative Efforts 117
Duration of Resuscitative Efforts 118
Asystole: An Agonal Rhythm? 118
Ethical Considerations 118
Transport of Patients in Cardiac Arrest 119
Bradycardia Case 120
Introduction 120
Rhythms for Bradycardia 120
Drugs for Bradycardia 121
Description of Bradycardia 122
Definitions 122
Symptomatic Bradycardia 122
Signs and Symptoms 122
Managing Bradycardia: The Bradycardia Algorithm 122
Overview of the Algorithm 123
Application of the Bradycardia Algorithm 124
Introauction 124
Identification of Bradvoardis 174
Primary Assessment 124
Are Signs or Symptoms Caused b\ Bradvoardis''- 124
Decision pomt: Adequate Perfusior ' 124
Treatmen4 Seouence Summarx 125
Treatment Sequence: Atropine 125
Treatment Sequence: Pacing 126
Treatment Sequence: Epinephrine, Dopamine 126
Next Actions 127
Transcutaneous Pacing 127
Introduction 127
Indications 127
Precautions 127
Technique 127
Assess Response to Treatment 128
Bradycardia With Escape Rhythms 128
Standby Pacing 128
Tachycardia: Stable and Unstable 129
Introduction 129
Rhythms for Unstable Tachycardia 129
Drugs for Unstable Tachycardia 130
The Approach to Unstable Tachycardia 130
Introduction f 130
Definitions 130
Pathophysiology of Unstable Tachycardia 131
Signs and Symptoms 131
Rapid Recognition Is the Key to Management 131
Severity 131
Indications for Cardioversion 131
Managing Unstable Tachycardia: The Tachycardia Algorithm 132
Introduction 132
Overview 132
Summary 133
Application of the Tachycardia Algorithm to the Unstable Patient 134
Introduction 134
Assess Appropriateness for Clinical Condition 134
Identify and Treat the Underlying Cause 134
Decision Point: Is the Persistent Tachyarrhythmia
Causing Significant Signs or Symptoms? 134
Perform Immediate Synchronized Cardioversion Determine tne Width of the ORS Comnlex
Cardioversion 13S
introduction 136
Unsynchronized vs Synchronized Shoe!:. - зг
Potential Problems With Synchronization 136
Energy Doses for Cardioversion 137
Energy Doses for Cardioversion 137
Synchronized Cardioversion Technique 137
Introduction 137
Technique 138
Stable Tachycardias 139
Rhythms for Stable Tachycardia 139
Drugs for Stable Tachycardia 139
Approach to Stable Tachycardia 139
Introduction 139
Questions to Determine Classification 140
Managing Stable Tachycardia: The Tachycardia Algorithm 140
In + rnHl ir'+inn 140
Overview 141
Application of the Tachycardia Algorithm to the Stable Patient 141
Introduction 141
Patient Assessment 141
BLS and ACLS Assessrpents 141
Decision Point: Stable or Unstable 141
IV Access and 12-Lead ECG 141
Decision Point: Narrow or Wide 142
Wide-Complex Tachycardias 142
Narrow QRS, Regular Rhythm 143
Tachycardia Algorithm: Advanced Management Steps 144
Immediate Post-Cardiac Arrest Care Case 145
Introduction 145
Rhythms for Post-Cardiac Arrest Care 145
Drugs for Post-Cardiac Arrest Care 145
Multiple System Approach to Post-Cardiac Arrest Care 145
Overview of Post-Cardiac Arrest Care 146
Managing Post-Cardiac Arrest Care: The Post-
Cardiac Arrest Care Algorithm 147
Application of the immediate Post-Cardiac Arrest Care Algorithm 148
introduction 148
Optimize Ventilation and Oxygenation 148
Treat Hypotension (SBP Less Thai: 90 mm He) ; 5f■
STEMI is Present or High Suspicion от AM: i5l
Coronary Reperfusion
Following Commands
Targeted Temperature Management
Advanced Critical Care
Post-Cardiac Arrest Maintenance Therap
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