Definition of ACLS

July 31, 2012

ACLS stands for “Advanced Cardiovascular Life Support”, and it is defined as a set of protocols used for the immediate treatment of stroke, cardiac arrest, and various other cardiovascular-related emergencies. This advanced form of life support expands upon basic CPR techniques by integrating the use of defibrillation, intubation, IV setup, ECG analysis, and emergency pharmaceuticals to sustain cardiac arrest patients. To be certified in ACLS means to be capable of providing high quality care and assistance during cardiovascular-related health emergencies, such as stroke and heart attack.

The American Heart Association created the guidelines for ACLS protocol, and updates them every few years to ensure that the latest medical information is integrated into the prescribed life support methods. This material is highlighted in the ACLS Provider Manual, developed by the AHA, and used by training programs and instructors. Early defibrillation and good quality chest compressions are emphasized in the certification material. According to research, these two components had the greatest effect on patient outcomes and improved survivability.

ACLS guidelines are organized into algorithms that are used to standardize treatment for cardiac emergencies and increase overall effectiveness. These instructions are presented visually in the form of flowcharts that list a series of yes or no questions to increase memorability for trainees. These protocols include correct dosages and what steps to take to optimize the pre-hospital treatment process.

The use of IV drugs is also unique to ACLS. An in-depth knowledge of emergency pharmaceuticals is necessary to become ACLS certified. Providers must analyze the patient’s condition to make sure that they can safely administer certain drugs, like epinephrine. If the patient shows signs of a drug overdose, they must know which treatment to use.

ACLS certified professionals are trained to utilize a complex set of clinical interventions to provide urgent treatment to patients in need of life support. BLS, basic life support, only prepares an individual to perform CPR, and BLS providers depend on an AED to tell them when and to what extent to administer a shock to the patient. In ACLS, the team leader analyzes the patient’s vital signs along with the rhythms presented on a manual defibrillator to determine when to shock the patient and how much electric charge is needed.  Team dynamics are a major focus during ACLS training, and medical professionals learn how to work effectively as a team and individually to enhance resuscitation methods.

Our Quick Guide to ACLS Review:

In case of a cardiac emergency, caused by any given reason, a set of steps based on clinical procedures can be deployed. These clinical interventions are called ACLS or Advanced Cardiac Life Support. ACLS is a combination of proper medications and procedures that when used effectively can help save lives . Advanced Cardiac Life Support has been divided in to separate (but inter-related) algorithms that are based on several steps.

Each algorithm is divided in to different stages in supporting a patient’s life. Here is how an algorithm advances:

No matter what is causing cardiac arrest and whatever procedure follows after assessing the root cause, there are a few initial steps that help save a patient’s life at the given instance. The initial steps are - assessing cardiac arrest and general management.

Assessing Patient

Each algorithm generally starts with the “Assessment”. Assessing the patient starts with feeling or recording the pulse rate. Recording the pulse rate not only helps a professional in assessing the cardiac arrest but can also in some cases signify the root cause.

For instance:

pulse rate is above 100 and below 150 beats per minute during Stable tachycardia

Pulse rate is above 150 beats/minute during Unstable tachycardia

Pulse rate is below 60 beats per minute in case of Bradycardia

Pulse rate is below 50 beats per minute, in case of symptomatic Bradycardia

Once the patient has been assessed for cardiac arrest the next step is general management of the patient.

General Management

The general management is the second step in following the essential algorithms. Understanding general management becomes easy if one grasps the ABC of it. The ABC is discussed as follows:

A for Airway Management

B for Breath Management

C for Circulation

Airway Management

General management starts with air passage management. In the scenario where the body is positioned so as the airway is blocked, the oxygen supply will become inadequate resulting in further collapse. Hence, it is very important to position one's body so that natural air passage is not blocked.

For maintaining natural air passage, it is important to help the patient lay down and place their head straight. If natural air passage is not supplying adequate oxygen, it should be supplied artificially. In such a case, Endotracheal Intubation aids.

Endotracheal Intubation or ET is an artificial procedure to make oxygen available for the patient. The procedure involves inserting an ET tube into the lungs via the mouth and larynx. This tube helps secure adequate oxygen supply to the body.

Breathing Management

The next step is breathing management. In addition to airway passage management, adequate oxygen is supplied to the body through breathing. If the patient is not breathing naturally, then his breath should be assisted with artificial means of breathing. For this purpose, a ventilator or bag valve mask can be used.

A bag valve mask works by being attached to the outer opening of the ET tube. The valve secures the air inside the bag. The bag fills the air inside such that on squeezing it is pumped inside the lungs through the tube. The American Heart Association has provided the proper air pumping procedure for proper inhalation and exhalations.

On the other hand, a ventilator is an electronic air pumping machine that is attached to the opening of the ET tube. For proper usage, a ventilator should be set to the specific setting - so the machine can work on its own in aiding the patient to breath.

Circulation

The next step for general management is circulation management. For managing circulations there are two procedures i.e.

In addition to these two procedures, medications are also employed for managing blood circulation and normalizing heart rhythm. Once general management is accomplished, the algorithm approaches to assessing the root cause and the mode of treatment takes a sudden turn. Later, the patients are treated according to the cause of cardiac arrest.

 


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