This document provides an overview of Advanced Cardiac Life Support (ACLS). It defines ACLS as a systematic approach to resuscitation. The core concepts of ACLS include airway management, BLS certification, early management of cardiac emergencies, use of electrical therapy like defibrillators, identification and treatment of cardiac arrhythmias, IV/invasive techniques, and pharmacology. It also reviews the 5 links in the adult chain of survival - activation of EMS, early CPR, defibrillation, ACLS protocols, and post-cardiac arrest care. Common cardiac rhythms like sinus tachycardia, atrial fibrillation, ventricular tachycardia, and asystole are depicted

2. ACLS
Introduction &
Rhythm Recognition
By
Dr. J. Saleem

3. What is ACLS
• Advanced Cardiac Life Support (ACLS) is a
systematic approach to resuscitation efforts.
• ACLS training gives rescuers a coordinated way
to approach critically ill patients, regardless of
response team size.

4. ACLS Core Concepts
1. Airway management
i. You should know how to insert or assist with ETT
(Endotracheal Tube).
ii. You should also know alternative ventilation techniques,
such as how to use a BVM (Bag Valve Mask) device and
LMA (Laryngeal Mask Airway).
2. BLS
i. You should be proficient in BLS and certified within the
last 2 years; or
ii. Are a BLS Instructor/Trainer and have conducted
workshops in BLS at least once a year for the past 2 years.

5. Single Handed E-C Technique
Single Handed E-O Technique

7. ACLS Core Concepts
3. Early management
You should know how to
manage the first 30 minutes of
emergencies that result from
such causes as:
• Acute Coronary Syndrome
• Cardiac Arrest
– medical
– associated with trauma
– in a pregnant patient
• Cardiac Tamponade
• Drowning / Near-Drowning
• Electrocution / Lightning
Strike
• Hypothermia
• Pneumothorax
• (Possible) Drug Overdose
• Stroke
• Thrombosis

8. ACLS Core Concepts
4. Electrical Therapy
You should know how to safely use electrical devices like:
i. Conventional Defibrillators
ii. Automated External Defibrillators (AEDs)
iii. Temporary Pacemakers (TPM)
5. Emergency conditions
i. You should be able to identify indications for ACLS,
such as Asystole, PEA, SVTs, VTach, and VFib.
ii. You should also be able to administer appropriate
treatment.

9. ACLS Core Concepts
6. I.V. and Invasive Techniques
You should be familiar with:
– Peripheral I.V. Line Insertion
– Central Line Insertion
– Intraosseous Cannulation
7. Pharmacology
You should know the action, indication, dosages, and
precautions for the major drugs used during ACLS, such
as adenosine, amiodarone, and epinephrine.

10. 5 Links in Adult Chain of Survival
1. Immediate recognition and activation of the
Emergency Medical Services (EMS) – call
1122
2. Early Cardio-Pulmonary Resuscitation (CPR)
with high-quality chest compressions
3. Rapid Defibrillation
4. Effective Advanced Cardiac Life Support
(ACLS)
5. Integrated post–cardiac arrest care

11. 5 Links in Adult Chain of Survival
1. Immediate recognition and activation of the
Emergency Medical Services (EMS) – call
1122
2. Early Cardio-Pulmonary Resuscitation (CPR)
with high-quality chest compressions
3. Rapid Defibrillation
4. Effective Advanced Cardiac Life Support
(ACLS)
5. Integrated post–cardiac arrest care

12. Step 3 - AED

13. Step 4 - ACLS
• Advanced Airway Management
• Administration of rhythm-appropriate I.V.
medications

14. Step 5 – Integrated After Care
Following Return Of Spontaneous Circulation
(ROSC), integrated post–cardiac arrest care
emphasizes the importance of comprehensive,
multidisciplinary care, including interventions to:
1. Optimize bodily functions;
1. Hemodynamic,
2. Neurologic, and
3. Metabolic and
2. The use of Therapeutic Hypothermia (Possibly)

15. Normal Cardiac Conduction

16. Normal ECG

17. Shocking the Heart
Cardioversion
• Planned / Scheduled
• Synchronized
• Low energy settings
– 25 to 150 J
• Chemical alternative
• Rx Atrial Arrhythmias
Defibrillation
• Unscheduled /Emergency
• Asynchronous
• High energy settings
– 200 – 360 J
• No Chemical Alternate
• Rx of Ventricular
Arrhythmias

18. Types of Defibrillators
Monophasic Vs. Biphasic Shock
• A monophasic shock only
travels in one direction from
one paddle to another
• a biphasic shock travels
from one paddle to the
other and then back several
times.
Types
1. Automated External
Defibrillators (AEDs)
2. Semi-Automated AEDs
3. Standard / Conventional
Defibrillators
4. Implanted Defibrillators (eg
DDD or DDI)

19. Sinus Tachycardia
Atrial Tachycardia
Atrial Flutter
Atrial Fibrillation

20. Wolfe-Parkinson-White (WPW) Syndrome
Multi-Focal Atrial Tachycardia (MAT)
Junctional Atrial Rhythm

21. Ventricular Premature Beats (VPCs) OR Premature Ventricular Contractions (PVCs)
Bigeminy
Trigeminy

22. Multiform VPCs
R on T resulting in a short run of V-Tach

23. V-Tach

24. V-Tach

25. V-Tach

26. V-Fib

27. Asystole

28. PEA

29. Wolfe-Parkinson-White (WPW) Syndrome

30. Normal Cardiac Conduction