This document provides an overview of an Advanced Cardiac Life Support (ACLS) review course and critical care transport training. It includes: 1) Objectives to review ACLS algorithms, recognize cardiac rhythms to select the appropriate treatment algorithm, and state interventions for each algorithm. 2) A review of the critical care transport process, including the steps to request, schedule, and conduct a safe transport with available resources. 3) Examples of cardiac rhythms and ACLS treatment algorithms, with questions to test recognition and appropriate interventions.

1. Critical Care Core Course Advanced Cardiac Life Support—Review & Lifeline: Critical Care Transport

2. Objectives ACLS—Review Review AHA ACLS algorithms* Utilize basic cardiac rhythm recognition to choose appropriate algorithm State at least one interventions for each algorithm Lifeline: Transport Review the Transport Process List the critical steps necessary to create a safe transport environment. Describe the Transport resources available at Johns Hopkins 12/23/2009 2 Critical Care Core Course--ACLS & Transport

3. ACLS—Review 12/23/2009 Critical Care Core Course--ACLS & Transport 3 * This review is not meant to replace formal ACLS Class

4. ACLSReview—Universal Algorithm 12/23/2009 Critical Care Core Course--ACLS & Transport 4 Key Points Airway Breathing Circulation Each min means 10 %↑Mortality http://circ.ahajournals.org/content/vol112/24_suppl/images/large/4FF2.jpeg

6. ACLSReview—Tachycardia Algorithm 12/23/2009 Critical Care Core Course--ACLS & Transport 6 Key Points Airway Breathing Circulation Each min means 10 %↑Mortality http://circ.ahajournals.org/content/vol112/24_suppl/images/large/9FF2.jpeg

9. ACLSReview— Bradycardia Algorithm 12/23/2009 Critical Care Core Course--ACLS & Transport 9 Key Points Airway Breathing Circulation Each min means 10 %↑Mortality http://circ.ahajournals.org/content/vol112/24_suppl/images/large/8FF1.jpeg

11. ACLSReview— Pulseless Algorithm 12/23/2009 Critical Care Core Course--ACLS & Transport 11 Key Points Airway Breathing Circulation Each min means 10 %↑Mortality http://circ.ahajournals.org/content/vol112/24_suppl/images/large/8FF1.jpeg

14. ACLSReview— Name This… 12/23/2009 Critical Care Core Course--ACLS & Transport 14 P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: http://www.m.auvilacom/images/BasicECG.gif

15. ACLSReview— Name This… P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: Normal Sinus Rhythm http://www.m.auvilacom/images/BasicECG.gif 12/23/2009 Critical Care Core Course--ACLS & Transport 15

16. ACLSReview— Name This… 12/23/2009 Critical Care Core Course--ACLS & Transport 16 P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: http://www.rnceus.com/case/images/wencke.gif

17. ACLSReview— Name This… P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: 2nd Degree AV Block Type I http://www.rnceus.com/case/images/wencke.gif 12/23/2009 Critical Care Core Course--ACLS & Transport 17

18. ACLSReview— Name This… 12/23/2009 Critical Care Core Course--ACLS & Transport 18 PR interval: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: http://www.m.auvilacom/images/BasicECG.gif

19. ACLSReview— Name This… PR interval: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: Sinus Bradycardia http://www.m.auvilacom/images/BasicECG.gif 12/23/2009 Critical Care Core Course--ACLS & Transport 19

20. ACLSReview— Name This… 12/23/2009 Critical Care Core Course--ACLS & Transport 20 P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: http://whttp://www.scottishirishhealthcare.com/article_images/ventricular_tachycardia.jpgww.m.auvilacom/images/BasicECG.gif

21. ACLSReview— Name This… P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: Ventricular Tachycardia http://whttp://www.scottishirishhealthcare.com/article_images/ventricular_tachycardia.jpgww.m.auvilacom/images/BasicECG.gif 12/23/2009 Critical Care Core Course--ACLS & Transport 21

22. ACLSReview— Name This… 12/23/2009 Critical Care Core Course--ACLS & Transport 22 P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: http://www.rnceus.com/case/images/Torades.gif

23. ACLSReview— Name This… P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: Torsades de Pointes http://www.rnceus.com/case/images/Torades.gif 12/23/2009 Critical Care Core Course--ACLS & Transport 23

24. ACLSReview— Torsades de Pointes 12/23/2009 Critical Care Core Course--ACLS & Transport 24 http://www.themdsite.com/graphics/Physician_04.jpg

25. ACLSReview— Name This… 12/23/2009 Critical Care Core Course--ACLS & Transport 25 P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm:

26. ACLSReview— Name This… P: QRS: T: Ventricular Rate: Atrial Rate: Rhythm: Narrow Complex Tachycardia 12/23/2009 Critical Care Core Course--ACLS & Transport 26

27. Objectives ACLS—Review Review AHA ACLS algorithms* Utilize basic cardiac rhythm recognition to choose appropriate algorithm State at least one interventions for each algorithm Lifeline: Transport Review the Transport Process List the critical steps necessary to create a safe transport environment. Describe the Transport resources available at Johns Hopkins 12/23/2009 27 Critical Care Core Course--ACLS & Transport

28. Lifeline: The Transport Process Provider orders a test/procedure requiring a road trip. RN faxes a completed Transport Request to HOPCOM HOPCOM calls to confirm details and schedule transport Transport Team transports patient to test/procedure Patient returned & Care transferred to staff on unit of origin 12/23/2009 Critical Care Core Course--ACLS & Transport 28

29. Lifeline: Rules of the Road What can we do to safely transport this patient now with the resources at hand? How long will the patient be off of the unit? What is the plan?!? 12/23/2009 Critical Care Core Course--ACLS & Transport 29

30. Lifeline: Transport Resources Lifeline Transport Team Providers Unit Staff Respiratory Therapy Testing/Procedure Area Staff 12/23/2009 Critical Care Core Course--ACLS & Transport 30