ACLS-Provider-Manual-Sample.Pdf

Advanced Cardiovascular Life Support

Provider Manual

Table of Contents Unit One: ACLS Overview ...... 6 Preparing for ACLS...... 6 Organization of the ACLS Course...... 6 Delivering the Most Up-to-Date Guidelines Available...... 7 ACLS Manual Updates At-A-Glance: 2020 to 2025...... 8

Unit Two: BLS and ACLS Surveys...... 10 BLS Survey...... 10 Adult BLS/CPR...... 11 ACLS Survey...... 12 Primary Assessment...... 13 Secondary Assessment...... 14

Unit Three: Team Dynamics...... 15

Unit Four: Systems of Care...... 17 Post-Cardiac Arrest Care...... 17 Acute Coronary Syndromes (ACS)...... 18 Acute Stroke Care...... 18 Education and Teams...... 19

Unit Five: ACLS Cases...... 20 BLS and ACLS Surveys...... 20 Respiratory Arrest...... 20 Basic Airway Management...... 22 Oropharyngeal Airway...... 22 Nasopharyngeal Airway...... 23 Advanced Airway Management...... 24 Suctioning the Airway...... 25 Ventricular Fibrillation, Pulseless Ventricular Tachycardia, PEA and Asystole...... 26 Cardiac Arrest: Ventricular Fibrillation (VF) with CPR and AED...... 26 Adult BLS/CPR...... 26 Using the Automated External Defibrillator...... 27 Cardiac Arrest...... 29 Manual Defibrillation for VF or Pulseless VT...... 33 Cardiac Arrest in Pregnant Women...... 33 Routes of Access for Medication Administration...... 35 2 © 2020 American Resuscitation Council ACLS Provider Manual

Insertion of an IO Catheter...... 36 Monitoring During CPR...... 37 Medications Used during Cardiac Arrest...... 37 When to Terminate Resuscitation Efforts...... 37 Post-Cardiac Arrest Care...... 38 Acute Coronary Syndrome (ACS)...... 40 ACS Algorithm...... 40 Bradycardia...... 43 Stable and Unstable Tachycardia...... 45 Tachycardia Algorithm...... 46 Opioid Overdose Algorithm...... 48 Acute Stroke...... 49 Suspected Stroke Algorithm...... 50

Unit Six: Commonly Used Medications in Resuscitation...... 52

Unit Seven: Rhythm Recognition ...... 55 Sinus Bradycardia...... 56 Sinus Tachycardia...... 57 Sinus Rhythm with First Degree Heart Block...... 57 Second Degree AV Heart Block...... 58 Third Degree Heart Block...... 59 Supraventricular Tachycardia (SVT)...... 59 Atrial Fibrillation (AF)...... 60 Atrial Flutter...... 60 Asystole...... 60 Pulseless Electrical Activity (PEA)...... 61 Ventricular Tachycardia (VT)...... 61 Ventricular Fibrillation (VF)...... 61 Myocardial Infarction (MI)...... 62

References...... 63

www.resuscitation.org 3 ACLS Provider Manual

List of Figures

Figure 1: BLS Survey Tasks...... 10 Figure 2: ACLS Survey Tasks...... 12 Figure 3: Team Location...... 15 Figure 4: In-Hospital Cardiac Arrest Chain of Survival...... 17 Figure 5: Outside-of-Hospital Cardiac Arrest Chain of Survival...... 17 Figure 6: One-Rescuer Ventilation...... 21 Figure 7: Two-Rescuer Ventilation...... 21 Figure 8: Oropharyngeal Airway...... 22 Figure 9: Nasopharyngeal Airway...... 23 Figure 10: BLS AED Algorithm...... 28 Figure 11: ACLS Cardiac Arrest PEA and Asystole Algorithm...... 31 Figure 12: ACLS Cardiac Arrest VT and VF Algorithm...... 32 Figure 13: ACLS In-Hospital Cardiac Arrest in Pregnancy Algorithm...... 34 Figure 14: Intraosseous Access...... 36 Figure 15: ACLS Post-Cardiac Arrest Care Algorithm...... 39 Figure 16: ACLS Acute Coronary Syndrome Algorithm...... 42 Figure 17: ACLS Bradycardia Algorithm...... 44 Figure 18: ACLS Tachycardia Algorithm...... 47 Figure 19: BLS Suspected Opioid Overdose Algorithm...... 48 Figure 20: Stroke Chain of Survival...... 49 Figure 21: Timeline for Treatment of Stroke...... 49 Figure 22: Standard ECG...... 55 Figure 23: Normal Sinus Rhythm...... 56 Figure 24: Sinus Bradycardia...... 56 Figure 25: Sinus Tachycardia...... 57 Figure 26: First Degree Heart Block...... 57 Figure 27: Second Degree Heart Block Type I...... 58 Figure 28: Second Degree Heart Block Type II...... 58 Figure 29: Third Degree Heart Block...... 59 Figure 30: Supraventricular Tachycardia...... 59 Figure 31: Atrial Fibrillation...... 60 Figure 32: Atrial Flutter...... 60 Figure 33: Ventricular Tachycardia...... 61 Figure 34: Ventricular Fibrillation...... 61

List of Tables

Table 1: ACLS Manual Updates At-A-Glance: 2020 to 2025...... 8 Table 2: Primary Assessment...... 13 Table 3: Secondary Assessment...... 14 Table 4: Team Dynamics...... 16 Table 5: Hs and Ts as Causes of PEA...... 30 Table 6: Routes for Medication Administration...... 35 Table 7: ACS Categorization...... 41 Table 8: Signs and Symptoms of Bradycardia...... 43 Table 9: Signs and Symptoms of Tachycardia...... 45 Table 10: ACLS Resuscitation Medications...... 52