Cardiac 1.36 Hs and Ts ACLS

H’S AND T’S OF ACLS

A mnemonic used to aid in remembering the possible causes of cardiac arrest. A variety of disease processes can lead to a cardiac arrest; however, they usually boil down to one or more of the "Hs and Ts".

H’s of ACLS T’s of ACLS

Causes Signs Treatment Causes Signs Treatment

Hypovolemia HR Fluid administration Toxins Prolonged QT Antidote Based on Narrow QRS Fluid challenge overdose Blood loss Tamponade HR Pericardiocentesis Hypoxia HR Patent airway (Cardiac) Narrow QRS Thoracotomy Cyanosis Ventilate JVD Mued heart

Hydrogen ABG (Low pH) Sodium bicarbonate Tension HR Decompression Ion (Acidosis) Low amplitude QRS Ventilate Pneumothorax Narrow QRS Chest tube Unequal breaths Tracheal deviation Ventilate (metabolic) Flat T waves with U Hyper/Hypokalemia Sodium bicarbonate wave (hypo) or (respiratory) Peaked Thrombosis EKG alteration Embolectomy Calcium Gluconate T waves with wide (coronary or Chest pain Fibrinolytics Insulin and D50 QRS (hyper) pulmonary) Narrow QRS Anticoagulants Albuterol SOB Angioplasty Stent Hypothermia Hypothermia Warming measures CABG

H’s Hypovolemia: A lack of circulating body uids, principally blood volume. This is usually (though not exclusively) caused by some form of bleeding, anaphylaxis, or pregnancy with gravid uterus. Hypoxia: A lack of oxygen delivery to the heart, brain and other vital organs. Rapid assessment of airway patency and respiratory eort must be performed. Hydrogen Ion: An abnormal pH in the body as a result of lactic acidosis which occurs in prolonged hypoxia and in severe infection, diabetic ketoacidosis, renal failure causing uremia, or ingestion of toxic agents or overdose of pharmacological agents. Hyper/Hypokalemia: Both excess and inadequate potassium can be life-threatening. Hypothermia: A low core body temperature, de ned clinically as a temperature of less than 35 degrees Celsius (95 degrees Fahrenheit).

T’s Toxins: Toxin ingestion is one of the most common causes of cardiac arrest. Prolonged QT is a common sign. Tamponade: Blood or other uids building up in the pericardium can put pressure on the heart so that it is not able to beat Tension Pneumothorax: The build-up of air into one of the pleural cavities, which causes a mediastinal shift. When this happens, the great vessels (particularly the superior vena cava) become kinked, which limits blood return to the heart Thrombosis: Hemodynamically signi cant pulmonary emboli are generally massive and typically fatal.

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