ACLS Course Info
This info is taken from the American Heart Association and used here for educational purposes.
Stat Life Medical Training conducts ACLS classes in Jacksonville FL
Advanced Cardiovascular Life Support
ACLS affects multiple links in the Chain of Survival, including interventions to prevent cardiac arrest, treat cardiac arrest, and improve outcomes of patients who achieve ROSC after cardiac arrest. The 2010 AHA Guidelines for CPR and ECC continue to emphasize that the foundation of successful ACLS is good BLS, beginning with prompt high-quality CPR with minimal interruptions, and for VF/pulseless VT, attempted defibrillation within minutes of collapse. The new fifth link in the Chain of Survival and Part 9: “Post–Cardiac Arrest Care” (expanded from a subsection of the ACLS part of the 2005 AHA Guidelines for CPR and ECC) emphasize the importance of comprehensive multidisciplinary care that begins with recognition of cardiac arrest and continues after ROSC through hospital discharge and beyond. Key ACLS assessments and interventions provide an essential bridge between BLS and long-term survival with good neurologic function.
In terms of airway management the 2010 AHA Guidelines for CPR and ECC have a major new Class I recommendation for adults: use of quantitative waveform capnography for confirmation and monitoring of endotracheal tube placement. In addition, the use of supraglottic advanced airways continues to be supported as an alternative to endotracheal intubation for airway management during CPR. Finally, the routine use of cricoid pressure during airway management of patients in cardiac arrest is no longer recommended.
There are several important changes in the 2010 AHA Guidelines for CPR and ECC regarding management of symptomatic arrhythmias. On the basis of new evidence of safety and potential efficacy, adenosine can now be considered for the diagnosis and treatment of stable undifferentiated wide-complex tachycardia when the rhythm is regular and the QRS waveform is monomorphic. For symptomatic or unstable bradycardia, intravenous (IV) infusion of chronotropic agents is now recommended as an equally effective alternative to external pacing when atropine is ineffective.
For 2010 a new circular AHA ACLS Cardiac Arrest Algorithm has been introduced as an alternative to the traditional box-and-line format. Both algorithms represent restructured and simplified formats that focus on interventions that have the greatest impact on outcome. To that end, emphasis has been placed on delivery of high-quality CPR with minimal interruptions and defibrillation of VF/pulseless VT. Vascular access, drug delivery, and advanced airway placement, while still recommended, should not cause significant interruptions in chest compression or delay shocks. In addition, atropine is no longer recommended for routine use in the management of pulseless electrical activity (PEA)/asystole.
Real-time monitoring and optimization of CPR quality using either mechanical parameters (eg, monitoring of chest compression rate and depth, adequacy of chest wall relaxation, length and duration of pauses in compression and number and depth of ventilations delivered) or, when feasible, physiologic parameters (partial pressure of end-tidal CO2 [Petco2], arterial pressure during the relaxation phase of chest compressions, or central venous oxygen saturation [Scvo2]) are encouraged. When quantitative waveform capnography is used for adults, guidelines now include recommendations for monitoring CPR quality and detecting ROSC based on Petco2 values.
Finally the 2010 AHA Guidelines for CPR and ECC continue to recognize that ACLS does not end when a patient achieves ROSC. Guidelines for post–cardiac arrest management have been significantly expanded (see Part 9) and now include a new Early Post–Cardiac Arrest Treatment Algorithm.