Advanced cardiac life support

1. ADVANCED CARDIAC LIFE
SUPPORT(ACLS)
- Prakash Khanal
INTERN,MBBS
CMC-TH
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2. Advanced cardiac life support
 Advanced cardiac life support or Advanced Cardiovascular Life
Support refers to a set of clinical interventions for urgent
treatment of cardiac arrest and other life threatening medical
emergencies as well as knowledge and skills to deploy those
interventions.
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3. Advanced cardiac life support
 ACLS is a series of evidence based responses simple enough
to be committed to memory and recall at the time of stress.
 AMERICAN HEART ASSOCIATION’s Protocols are considered
as Gold Standard ACLS Protocols. It gets reviewed every 5
years.
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4. IMPORTANCE OF BLS IN ACLS
 ACLS is built heavily upon the foundation of BLS
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5. AHA Adult Chain of Survival
 1. Immediate recognition of cardiac arrest and activation of the emergency
response system
 2. Early CPR with an emphasis on chest
 compressions
 3. Rapid defibrillation
 4. Effective advanced life support
 5. Integrated post–cardiac arrest care
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6. AHA PEDIATRIC Chain of Survival
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8. Adult advanced cardiovascular life support
 Shockable
1. Ventricular Tachycardia
2. Ventricular Fibrillation
 Nonshockable
1. Asystole
2. Pulseless Electrical Activity (PEA)
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9. Ventricular tachycardia
• .R-R interval usually regular, not always
• QRS not preceded by p wave.
• Wide and bizzare QRS.
• Difficult to find seperation between QRS and T wave
• Rate=100-250 bpm
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10.  A severely abnormal heart rhythm (arrhythmia) that can be life-threatening.
 No identifiable P, QRS or T wave
 Emergency- requires Basic Life Support
 Rate cannot be discerned, rhythm unorganized
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11. Asystole
 a state of no cardiac electrical activity, hence no contractions of the myocardium
and no cardiacoutput or blood flow.
 Rate, rhythm, p and QRS are absent
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12. Pulseless electrical activity
• Pulseless electrical activity (PEA)
• unresponsiveness and no palpable pulse
• some organized cardiac electrical activity.
• previously referred to as electromechanical dissociation
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17. H’s T’s
Hypoxia Toxins
Hypovolemia Tamponade (cardiac)
Hydrogen ion(acidosis) Tension pneumothorax
Hypo-/hyperkalemia Thrombosis, pulmonary
Hypothermia Thrombosis, coronary
17 Treatable Causes of Cardiac Arrest: The H’s and T’s

18. POST CARDIAC ARREST CARE
Objectives
 Optimize cardiopulmonary function and vital organ perfusion.
 After out-of-hospital cardiac arrest, transport patient to an appropriate hospital
with a comprehensive post–cardiac arrest treatment
 Transport the in-hospital post– cardiac arrest patient to an appropriate critical-care
unit
 Try to identify and treat the precipitating causes of the arrest and prevent
recurrent arrest
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20. THANK YOU
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