REVIEW advance cardiac life support ITS PREPARE YOU TO GET ACLS CERTIFICATE FOR STUDENT AND NURSE PRACTITIONER READ THIS AND PRACTICE GOOD LUCK

1. AHMAD ALSHARIEF
NURSING QUALITY COORDINATER
BSN.ANP.RN. ACLS PROVIDER
ADVANCED CARDIAC LIFE SUPPORT (Review )

2. ADVANCED CARDIAC LIFE SUPPORT
OUTLINE
➢INTRODUCTION
➢Normal heart anatomy and physiology
➢Basic ECG
➢ACLS Cases
1.Respiratory arrest
2.Cardiac arrest
3.Bradycardia
4.Tachycardia
➢POST CARDIAC ARREST

3. INTRODUCTION
• Advanced cardiac life support (ACLS) is a
group of procedures and techniques that
treat immediately life-threatening
conditions, including cardiac arrest, shock,
stroke, and trauma. ACLS procedures and
techniques are arranged into algorithms.
• The goal of (ACLS) is to achieve the best
possible outcome for individuals who are
experiencing a life-threatening event.

4. Adult Chain of Survival

5. NORMAL HEART ANATOMY AND PHYSIOLOGY

6. Cardiac conduction system
and relationship with ECG

7. BASIC ECG

8. BASIC ECG
The horizontal axis of the EKG paper records time
5 Large boxes = 1 second
1 large box= 0.2 seconds
Each large box =5 small boxes
1 small box =0.04 seconds
The vertical axis records EKG amplitude (voltage).
Two large boxes =1 millivolt (mV).
One large box= 0.5 mV
Each small box equals 0.1 mV.

9. Interpreting the ECG
•WHAT IS NORMAL ECG ?

10. Interpreting the ECG
•The P wave represents depolarization of the atria.
•The PR interval reflects the time the electrical impulse takes to
travel from the sinus node through the AV node.
•The QRS complex represents the rapid depolarization of the
right and left ventricles.
•The T wave represents the repolarization of the ventricles.

11. ACLS Cases
THE ACLS SURVEY (A-B-C-D)

12. ACLS Cases
Respiratory arrest
• Respiratory arrest is a condition that
exists at any point a patient stops
breathing or is ineffectively
breathing.
• the response to respiratory arrest
follows the same process as any
other emerging resuscitation,
namely BLS and ACLS sequences.

13. ACLS Cases
TYPES OF VENTILATION

14. ACLS Cases
Cardiac arrest
1. VENTRICULAR FIBRILLATION AND PULSELESS VENTRICULAR
TACHYCARDIA
2. ASYSTOLE
3. Pulseless Electrical Activity (PEA)

16. ACLS Cases
ACUTE CORONARY SYNDROME
•Acute Coronary Syndrome (ACS) is a due to
decreased or stop blood flow in the coronary
arteries such that part of the heart muscle is
unable to function properly or dies.
•ACS is a name given to three types of coronary
artery disease that are associated with sudden
rupture of plaque inside the coronary artery:
1) unstable angina.
2) Non-ST segment elevation myocardial
infarction (NSTEMI).
3) ST segment elevation myocardial infarction or
heart attack (STEMI).
.

17. ACLS Cases
ACUTE CORONARY SYNDROME
Past History :
❖ Medical history :
• Diabetes Mellitus 6 years ago
• Hypertension 4 years ago .
❖ Surgical history:
Previous hospitalization :cataract surgery 6years ago
Family history: negative.
Personal and social history: non smoker patient on
diabetic diet , low salt diet. social person and lives with
his family with out any social problems.
Sleeping pattern : normal sleeping not interrupted .

18. ACLS Cases
Bradycardia
• defined wherein an individual has a resting heart rate of under 60
beats per minute.
• Example :
1.Heart block
2.Sinus bradycardia

19. Vital Signs
*according to pain scale
General appearance:
.Restless, fatigue and aggressive
Neurological assessment:
Glascow coma scale (GCS) 15/15,Conscious and oriented to time
and place
P.S SPO2 RR BP PR TEMP
7/10* 99% 24/min 177/79mmhg 89/MIN 37.1
Clinical Case Presentation
Physical assessment:

20. ACLS Cases
Tachycardia
•is a condition that makes your heart beat more than 100
times per minute.
•Example:
1. Atrial fibrillation
2. Supraventricular tachycardia
3. Ventricle tachycardia

21. Clinical Case Presentation
Physical assessment:
• Gastrointestinal system :
NAD , Abdomen is soft and lax no tenderness .
• Genitourinary system :
NAD, Yellowish clear urine output, avoided freely.
• Upper and lower limbs:
NAD, capillary refill<3sec .
• Psychological assessment :
Fear, aggressive and anxiety .

22. ACLS Cases
POST CARDIAC ARREST
• Return of spontaneous circulation is the
resumption of a sustained heart rhythm that
perfuse the body after cardiac arrest. It is
commonly associated with significant respiratory
effort. Signs of include breathing, coughing, or
movement and a palpable pulse or a
measurable blood pressure.

23. Laboratory investigation result
ARTERILA BLOOD GASS ( ABGs)
PO2 SPO2 PCO2 HCO3 PH
96% 24.2 36.2 90 7.36
NORMAL VALUE RESULT BLOOD CHEMISTRY
135-145 135mmol/L Na
3.9-6.2 8.74mmol/l FBS
3.5-5.0 3.4mEq/L K
NORMAL VALUE RESULT CARDIAC ENZYMES
20 - 200 539u/l CK
4.9-6.2 70u/l CK-MB
NORMAL VALUE RESULT LIPID PROFILE
100-129 288U/L LDL
1.0-1.3 0.88 mmol/L HDL
3.4-5.7 6.7 mmol/l CHOLESTEROL
NORMAL VALUE RESULT COUAGULATION PROFLIE
11 to 13.5 14.0 Seconds PT
25 to 35 45.1 Seconds PTT
0.8 to 1.1 1.07 Seconds INR

24. Don’t forget that
If you want to be confident and qualified in ACLS
process you should to :
1. Be aware and have knowledge about ECG
2. Aware about the CPR medication
3. Be familiar how to use the equipment
4. Keep reviewing and updating
5. Be calm in the scene of CPR and take the step
6. Be proactive
LIFE IS MATTER WE SHOULD TO SAVE IT

25. THANK
YOU