Advanced cardiac life support (ACLS) is used to diagnose and treat emergencies, and the protocols and treatments of ACLS have been organized into algorithms. An algorithm is defined as a step-by-step procedure for solving a problem.
The following is an example of an ACLS algorithm:
ACLS algorithms a) start with a clinical sign/symptom, b) provide a diagnosis, c) outline the treatment options and provide the clinician with alternative treatments if the clinical picture changes or any particular treatment is not effective. There are ACLS algorithms for acute coronary syndromes, bradycardia, cardiac arrest, pulseless electrical activity, and many other medical emergencies.
Each algorithm provides physicians and nurses with an organized, step-by-step process for responding to these emergencies. The algorithms are essential knowledge for health care professionals who work in acute care settings, and they have been proven to be highly effective. However, as with any clinical tool, they cannot simply be applied: they must be used correctly.
Don’t forget the basics. The first step in ACLS is always ABCD: assess the airway, breathing, and circulation, and determine whether defibrillation is needed. Remember: Advanced cardiac life support – ACLS – is an extension of basic life support – BLS – and BLS always starts with ABCD.
ACLS algorithms should be used as a guide. The ACLS algorithms are not absolute standards of care and they are not intended to replace good clinical judgment. Situations change and you may have to use treatments, drugs, etc. that are not included in a particular algorithm, or you may have to begin a new algorithm. Understand the algorithms and use them when indicated - but always be aware of their limits.
Don’t hesitate. The key word to remember when responding effectively to emergencies is early: early activation of the EMS system; early application of BLS; early application of the ACLS algorithms; and early application of ACLS algorithms - they are only practical if you know the algorithms.
Practice and repetition are critical. The ACLS algorithms are complex and they require the practitioner to understand airway management, drugs, drug dosing, the basics of iv access, the basics of cardioversion and defibrillation, etc. Applying the algorithms requires a lot of learning, and that requires a lot of practice and repetition.