Lx8LSS 18AlnlnC SCLu1lCnS - SAn ulLCC - SAn CLLMLn1L - 1.888.813.0313 - WWW.Lx8LSS18AlnlnC.

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AddlLlonal maLerlal creaLed Lo enhance and supplemenL Lhe learnlng experlence and ls noL APA approved
ACLS SLudy Culde 2011 updaLed 8-2012, age 1 1CL]
!"#$ $&'() *'+(, -.//
See www.hearL.org/eccsLudenL. 1he code ls found ln Lhe ACLS rovlder Manual page ll.

1he ACLS rovlder exam ls 30-muLlple cholce quesLlons. asslng score ls 84. SLudenL may mlss 8 quesLlons. lor
sLudenLs Laklng ACLS for Lhe flrsL Llme or renewlng sLudenLs wlLh a currenL card, exam remedlaLlon ls permlLLed should
sLudenL mlss more Lhan 8 quesLlons on Lhe exam. vlewlng Lhe ACLS book ahead of Llme wlLh Lhe onllne resources ls
very helpful. 1he Amerlcan PearL AssoclaLlon llnk ls www.hearL.org/eccsLudenL and has an ACLS recourse Self-
AssessmenL, supplemenLary wrlLLen maLerlals and vldeos. 1he code for Lhe onllne resources ls on Lhe ACLS rovlder
Manual page ll. 8aslc uysrhyLhmlas knowledge ls requlred ln relaLlon Lo asysLole, venLrlcular flbrlllaLlon, Lachycardlas
ln general and bradycardlas ln general. SLudenL does noL need Lo know Lhe lns and ouLs of each and every one. lor
1achycardlas sLudenL need Lo dlfferenLlaLe wlde complex (venLrlcular Lachycardla) and narrow complex
(supravenLrlcular Lachycardla or Sv1).

BLS Overview CAB
ush Pard and lasL-8epeaL every 2 mlnuLes
AnyLlme Lhere ls no pulse or unsure abouL a pulse - do
CCM8LSSlCnS
LlemenLs of good C8
- 8aLe-aL leasL 100
- 8ecoll
- Compresslon depLh aL leasL 2 lnches
- Mlnlmlze lnLerrupLlons (less Lhan 10 seconds)
- Avold excesslve venLllaLlon
- SwlLch compressors every 2 mln or 3 cycles
lf ALu doesn'L prompLly analyze rhyLhm: compresslons.

Tachycardia with a Pulse
- lf unsLable (wlde or narrow) - go sLralghL Lo
synchronlzed cardloverslon
- lf sLable narrow complex
- obLaln 12 lead
- vagal maneuvers
- adenoslne 6mg 8Alu lv, followed by 12mg


Stroke
ClnclnnaLl re-PosplLal SLroke Scale
laclal uroop, Arm urlfL, Abnormal Speech

rLA can be glven wlLhln 3 hours from sympLom onseL.
lmporLanL Lo LransporL paLlenL Lo an approprlaLe
hosplLal wlLh C1 capablllLles. lf C1 noL avallable dlverL Lo
Lhe closesL hosplLal (l.e. 13 mln away) wlLh C1

Acute Coronary Syndromes
vlLal slgns, 02, lv,
12 Lead for C, eplgasLrlc paln, or rhyLhm change
Defibrillation

unresponslve pauenL,
no breaLhlng, or no
normal breaLhlng
AcuvaLe Lmergency
response and geL ALu
SLarL C8, shock lf
lndlcaLed
lncluded ln rlmary
Survey
Shock as soon as
debrlllaLor ls avallable
May conunue
compresslons whlle
debrlllaLor ls charglng
8e sure oxygen ls noL
blowlng over chesL
durlng debrlllauon
Pands free pads allow
for a more rapld
debrlllauon

Lx8LSS 18AlnlnC SCLu1lCnS - SAn ulLCC - SAn CLLMLn1L - 1.888.813.0313 - WWW.Lx8LSS18AlnlnC.nL1
AddlLlonal maLerlal creaLed Lo enhance and supplemenL Lhe learnlng experlence and ls noL APA approved
ACLS SLudy Culde 2011 updaLed 8-2012, age 2 1CL]
Waveform Capnography in ACLS (PETCO2)
Allows for accuraLe monlLorlng of C8
MosL rellable lndlcaLor for L1 Lube placemenL



Cardiac Arrest
Shockable 8hyLhms:
- venLrlcular llbrlllaLlon (vl)
- venLrlcular 1achycardla (v1) wlLhouL pulse

8lphaslc: 120-200! Monophaslc: 360!

non-Shockable 8hyLhms:
- LA
- AsysLole
- 2 mlnuLe cycles of compresslons, shocks (lf
vl/v1), and rhyLhm checks.
- Lpl 1 mg every 3-3 mlnuLes (preferred meLhod lv)
- nC MC8L A18ClnL for AsysLole and LA
- venLllaLlons - 30:2 8aLlo
- 8escue breaLhlng - 1 breaLh every 3-6 sec
- lf advanced alrway - 8-10 venLllaLlons/mlnuLe

Treat reversible causes (Hs and Ts)
0ypoxla or venLllaLlon problems
0ypovolemla
0ypoLhermla
0ypo-/hyper-kalemla
0ydrogen lon (12+(34+4)

5amponade, cardlac
5enslon pneumoLhorax
5oxlns - polsons, drugs
5hrombosls - coronary (AMl) - pulmonary (L)





Bradycardia
need Lo assess sLable versus unsLable.
lf sLable, monlLor, observe, and consulL.

lf unsLable. . .
-ALroplne 0.3mg lv. Can repeaL C3-3 mlnuLes.
Maxlmum dose=3mg (lncludlng hearL blocks)
- lf ALroplne lneffecLlve
- 1ranscuLaneous paclng
- uopamlne lnfuslon (2-10mcg/kg/mln)
- Lplnephrlne lnfuslon (2-10mcg/mln)

Return of Spontaneous Circulation (ROSC)
Post Resuscitation Care



Points to Ponder
CCM8LSSlCnS are very lmporLanL.
8lgor morLls ls an lndlcaLor of LermlnaLlon of efforLs.
Slmple alrway maneuvers, such as a head-LllL, may
help.
1he Medlcal Lmergency 1eams (ML1) can ldenLlfy and
LreaL pre-arresL slLuaLlons.
Conslder LermlnaLlng efforLs afLer deLerloraLlon Lo
asysLole and prolonged resusclLaLlon Llme.


use of Amerlcan PearL AssoclaLlon maLerlals ln an educaLlonal course does noL represenL course
sponsorshlp by Lhe Amerlcan PearL AssoclaLlon. Any fees charged for such a course, excepL for a
porLlon of fees needed for APA course maLerlals, do noL represenL lncome Lo Lhe AssoclaLlon.

<10
- Assess C8
CuallLy
>10
- Compresslons
AdequaLe
33-40
- osL ArresL
1argeL range
- MalnLaln 02 saL>94
- Conslder adv. alrway and waveform
capnography
- uo noL hypervenulaLe
6+74& 87+37+&)
Cpumlze venulauon
and Cxygenauon
- lv bolus (1-2L nS or L8)
- vasopressor lnfuslon
- Lplnephrlne
- uopamlne
- Conslder LreaLable causes
- 12-Lead LCC - Look for S1LMl lf so,
caLh lab
1reaL PypoLenslon
S8<90mmPg
- ?es - hypoLhermla conLralndlcaLed
- no - conslder lnduced hypoLhermla
uoes Lhe pauenL
follow commands?