Advanced Cardiovascular Life Support

Advanced Cardiovascular Life Support

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17.10 лв.

Етикети: Advanced Cardiovascular Life Support, advancedcardiovascularlifesupport, Ксерокопия

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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
 
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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
 
i he Ht'si 10 r/iinutes 66
 
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
 
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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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