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Advanced cardiac life support (ACLS): Clinical
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Advanced cardiac life support, or ACLS, is a structured way to respond to an unresponsive person with cardiac arrhythmias and cardiac arrest.
ACLS can be done by an individual or by a team that’s led by a team leader.
When we suspect a person may be in need of assistance, the first thing we need to do is determine their level of consciousness.
If they're not responsive, check their carotid pulse for about 10 seconds. If there's no pulse, first immediately activate the emergency response system to get more help and an AED or defibrillator. Then, move on to the ACLS algorithm.
The big picture goal of CPR is to maintain blood flow to the brain while a patient is pulseless. Because the patient’s heart is not functioning, the team is mechanically squeezing the heart to ensure blood flows to the brain.
In a person over 8 years of age, chest compressions are done by placing the heel of one hand in the center of the chest, then placing the other hand on top, interlocking the fingers, and without flexing the elbows, pushing down on the chest to a depth of at least 5 centimeters or 2 inches - which is about the same size as a closed fist lengthwise.
Compressions are done at a rate of about 100 compressions per minute, which you can remember if you do them to the beat of “Staying alive” by the Bee Gees.
Additionally, the team attempts to artificially ventilate the patient so oxygen can enter the lungs and carbon dioxide can leave the lungs.
The options for ventilation usually involve a bag valve mask device to push air in.
A bag valve mask can be applied directly to the person’s mouth, or with an oral airway, a supraglottic airway like a laryngeal mask airway or LMA, or an endotracheal tube.
ACLS is a set of clinical interventions that are designed to save the lives of people who are experiencing cardiac arrest. The main aim of ACLS is to improve the chance of survival by restoring a normal heart rhythm as quickly as possible.
The key components of ACLS include: 1) providing CPR (cardiopulmonary resuscitation) 2) using an automated external defibrillator (AED) 3) giving oxygen therapy 4) using drugs to treat arrhythmias (abnormal heart rhythms).
The ACLS guidelines are designed to help healthcare providers make rapid, informed decisions about the best way to treat a person in cardiac arrest.
Some of the key interventions included in ACLS are: providing oxygen to the patient, performing chest compressions, and using an automated external defibrillator (AED). Healthcare providers may also use medications such as adrenaline and atropine to help support the patient's heart function.
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