ACLS Primary Survey
The primary objective of the ACLS Primary Survey is to assess the airway, breathing, and circulation of the patient who is unresponsive or in cardiopulmonary distress.
Recognize the need to proceed from the BLS Survey to more advanced management.
This algorithm exercise makes some underlying assumptions before you start.
- The scene is safe and secured.
- Protective equipment is utilized.
- No sign of death is obvious
- Airway: Emphasis is on maintaining the airway: consider an advanced airway if needed. Confirm correct placement of an advanced airway, and secure the advanced airway device.
- Breathing: Bag-valve mask ventilation should be utilized for ventilation, and excessive ventilation should be avoided. Monitor adequacy of ventilation and oxygenation. Supplemental oxygen should be given for oxygen saturation less than 94%.
- Circulation: IV, O2, monitor.
- Obtain IV access, attach ECG leads, identify and monitor arrhythmias. Give IV fluid as needed. Use defibrillation if appropriate.
- Differential diagnosis: Assess the patient for reversible causes and contributing factors.
During the ACLS resuscitation, if bag-valve mask ventilation is inadequate, placement of an advanced airway, including a Combitube, LMA, or endotracheal intubation should be considered. Compressions should not be interrupted. Weigh the consideration of interruption of CPR against the benefit of an advanced airway, and consider waiting until patient has not responded to CPR and defibrillation.
Register and Prepare for the ACLS Certification Exam
Register and Prepare for the ACLS Recertification Exam