The document provides an overview of Advanced Cardiac Life Support (ACLS). It defines ACLS as a set of clinical interventions for urgent treatment of cardiac arrest and other life-threatening emergencies, as well as the knowledge and skills to deploy those interventions. The document notes that ACLS protocols from the American Heart Association are considered the gold standard and are reviewed every 5 years. It then discusses the Adult and Pediatric Chains of Survival and describes approaches for shockable and nonshockable cardiac rhythms like ventricular tachycardia, asystole, and pulseless electrical activity. Finally, it outlines objectives for post-cardiac arrest care.

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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