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- 1. ACLS??? PRESENTED BY- SAYMA KHAN NURSING OFFICER ELMCH
- 3. INTRODUCTION..... • ACLS refers to a set of clinical guidelines for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused cardiac arrest, using advanced medical procedures, medications, and techniques. NC.
- 4. ACLS... • These life-threatening conditions range from dangerous arrhythmias to cardiac arrest. • ACLS algorithms frequently address at least five different aspects of peri cardiac arrest care- i. Airway management ii. Ventilation iii. CPR compressions iv. Defibrillation v. Medications
- 5. 1-AIRWAY MANAGEMENT • Maintain patient airway using the head-tilt, chin- lift. • Rescue breathing can be mouth-to- mouth breathing. • Or airway management by equipments .
- 6. 2-VENTILATION In the absence of an advanced airway during CPR, current guidelines based on very limited evidence recommend two positive pressure breaths after every 30 chest compression. These breaths should be of an inspiratory time of 1 s and produce a visible chest wall rise.
- 7. 3-CPR COMPRESSIONS • CPR is an emergency procedure consisting of chest compressions often combined with artificial ventilation. • Chest compressions for adults between 5cm and 6cm deep and a rate at least 100 to 120 per minute. • Chest compression to breathing ratios is set at 30 to 2 in adults
- 8. 4-DEFIBRILLATION • Defibrillation depolarize the critical mass of myocardial cell at once. • 1st paddle on the right of the chest just below the clavicle. • 2nd at precordial, region. • Paddle should be applied with pressure equivalent to 10kg. Paddle Size- Adult; 13cm Children; 8cm Infant; 4.5cm
- 10. 5-MEDICATIONS • Adrenaline(all types of cardiac arrest) 1mg every 3- 5 min. • Amidarone(VF,VT)- 1st dose:300mg IV bolus, 2nd dose 150mg. • Lidocaine (if amidarone is not available) • Sodium bicabonate(only if cardiac arrest is associated with hyperkalemia or tricyclic anti- depressent overdose) • Calcium gluconate.
- 11. ACLS TEAM.. • ACLS generally requires a team of trained individuals... i. Team leader ii. Back up leader iii. 2 CPR performer iv. An airway respiratory specialist v. An IV access and medication vi. A monitor, defibrillator or ventilator attendant D.
- 12. FLOW CHART OF ACLS UNRESPONSIVE CALL FOR HELP START BLS
- 13. ATTACH MONITER & DEFIBRRILATOR WHEN AVALIABLE CHECK RHYTHM 1ST SHOCK (150-200 BIAPHASIC) CPR 30:2 (2min) 2ND SHOCK(150- 360)
- 14. CPR30:2 (2min) ADRENALINE 1MG IV EVERY 3-5 MIN 3RD SHOCK CPR 30:2 (2MIN) IF PULSE PRESENT: START POST RESUSCITATION CARE
- 15. IF PULSE NOT SEEN FURTHER SHOCK AFTER EACH 2 MIN PERIOD OF CPR. OR STILL NO PULSE SEEN AND ASYSTOLE SEEN: CONTINUE THE CPR AND SWTICH ON TO NON SHOCKABLE TREATMENT.