The document discusses Advanced Cardiac Life Support (ACLS). ACLS refers to emergency treatment for cardiac arrest and other cardiovascular emergencies, including the skills to perform interventions. The aim of ACLS is to restore normal heart rhythm and circulation by treating reversible causes. It outlines the basic steps and guidelines for cardiac arrest response, including assessing the patient, calling for help, performing high-quality chest compressions, using an automated external defibrillator, and treating potentially correctable causes.

1. ACLS
Sumi Singh
Nepal Medical College and Teaching Hospital

2. ACLS
• Advanced cardiac life support (ACLS) refers to a set
of clinical interventions for the urgent treatment
of cardiac arrest, stroke and other life-threatening
cardiovascular emergencies, as well as the
knowledge and skills to deploy those interventions.
• AIM:
• To restore normal cardiac rhythm and cardiac
output by correcting reversible cause

4.  Patient response
 Open airway
 Look, Listen, Feel
 Check for normal breathing
Caution agonal breathing
 Check for signs of life

5.  Pulse check if trained to do so
 Take less than 10 seconds for
assessment
 Call for help early

9.  30:2
 Compressions
 Centre of chest
 5-6 cm depth
 2 per second (100-120 min-1)
 Maintain high quality
compressions
 with minimal interruption
 Continuous compressions once
airway secured
 Switch compression provider
every 2 min to avoid fatigue

10. Team Means:
Monitor
Skilled Persons
Drugs
Start With Monitor

11. Bizarre irregular
waveform
No recognisable QRS
complexes
Random frequency and
amplitude

12. Monomorphic VT
– Broad complex rythm
– Rapid rate
– Constant QRS morphology
Polymorphic VT
– Torsade de pointes

13. Absent ventricular (QRS) activity
Atrial activity (P waves) may persist
Rarely a straight line trace

14. Clinical features of cardiac arrest
ECG normally associated with an output

16. H’s and T’s
Treatable causes of cardiac arrest
•Hypoxia
•Hypovolemia
•Hydrogen ion
(acidosis)
•Hypokalemia
•Hyperkalemia
•Hypothermia
•Thrombosis
(pulmonary)
•Thrombosis
(coronary)
•Tamponade
•Tension
pneumothorax
•Toxins

17. Return of Spontaneous Circulation:
Post-Cardiac Arrest Care