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What Counts as Excessive Ventilation in ACLS?

Excessive ventilation occurs when rescue breaths are delivered with too much volume, too quickly, or too frequently, surpassing the recommended ventilation rates during cardiopulmonary resuscitation. According to current ACLS guidelines, providers should aim to deliver one breath every 6 seconds (10 breaths per minute) once an advanced airway is in place. Without an airway, the recommended ratio remains 30 compressions to 2 breaths. Anything beyond these targets risks disrupting the delicate balance of circulation, respiratory function, and oxygenation.

Common Signs of Gastric Inflation and Over-Ventilation

Recognizing excessive ventilation in real time can be difficult, especially in the high-stress environment of a code. However, key indicators include:

Visible over-inflation of the chest, or a chest rise that is too rapid or forceful
Gastric distension, signaling that air may be entering the stomach instead of the lungs
Ventilations delivered faster than every 6 seconds or without full exhalation between breaths

Common Causes of Respiratory Over-Ventilation

Anxiety and adrenaline: In high-pressure situations, it’s natural to default to faster, more forceful breaths.
Incorrect bag-valve-mask (BVM) technique: Poor hand positioning, excessive squeezing, or lack of visual feedback can easily lead to over-delivery of air.
Over-reliance on BVM devices: Without capnography or feedback tools, BVM ventilation can be imprecise and hard to regulate consistently.

Difference Between Adequate, Minimal, and Excessive Ventilation

Adequate ventilation means delivering just enough air to cause visible chest rise at the correct rate—approximately one breath every 6 seconds (10 breaths per minute) with an advanced airway. The goal is to support oxygenation and carbon dioxide removal without interfering with circulation.

Minimal ventilation refers to under-ventilation—either too little air per breath or too few breaths per minute. This can lead to hypoxia and carbon dioxide buildup, both of which compromise organ perfusion and neurologic recovery.

Excessive ventilation, by contrast, occurs when breaths are delivered too forcefully, too frequently, or with too much volume. This raises intrathoracic pressure, impairs venous return, lowers cardiac output, and increases the risk of complications like gastric inflation and aspiration.

Effects of Excessive Ventilation on the Patient

When ventilation exceeds recommended rate, volume, or pressure limits. The physiological consequences can be severe and far-reaching. Even well-intentioned efforts can compromise the effectiveness of resuscitation and increase the risk of complications.

Below are the most critical effects of excessive ventilation during ACLS:

Decreased Cardiac Output

Too much air pressure in the chest makes it harder for blood to return to the heart. This reduces how much blood the heart can pump, which means less oxygen reaches the brain and other vital organs.

Altered Blood Gas Levels

Breathing too quickly blows off too much carbon dioxide, which can throw off the body’s chemical balance. This can shrink the blood vessels in the brain, reducing the oxygen it gets and worsening outcomes.

Interruptions During Chest Compressions

Focusing too much on giving breaths can lead to unnecessary pauses in CPR. These interruptions lower the chances of getting the heart started again.

Compromised Lung, Heart, and Gas Dynamics

Pushing in too much air can overfill the lungs and crowd the heart. This makes it harder for oxygen to move through the body and can make CPR less effective.

Gastric Inflation and Aspiration

Too much or too forceful breathing can send air into the stomach instead of the lungs. This raises the risk of vomiting and choking, which can make the situation worse.

Barotrauma and Alveolar Overdistention

Using too much air or squeezing the bag too hard can damage the lungs. This may cause air leaks or make it harder for the lungs to work properly after CPR.

Reduced Coronary and Cerebral Perfusion

All these issues together can reduce blood flow to the two organs that need it most during cardiac arrest: the heart and the brain.

Why Maintaining Optimal Air, Gas Exchange, and Oxygen Levels is Vital for Patient Survival

During cardiac arrest, the body’s ability to exchange gases is already compromised. That makes it even more critical to deliver oxygen efficiently and remove carbon dioxide without disrupting circulation. Proper ventilation supports this delicate respiratory balance by ensuring that oxygen reaches vital organs and waste gases are eliminated, all while allowing the heart to refill and pump effectively.

When oxygen levels drop too low, tissue hypoxia sets in, threatening the brain and heart. But delivering too much air too quickly can be just as dangerous, impairing venous return, reducing cardiac output, and causing harmful shifts in blood gas levels.

Preventing the Risks of Respiratory Complications

Preventing excessive ventilation starts with vigilance, teamwork, and adherence to ACLS best practices. Here are key strategies to reduce the risk of over-ventilating during a resuscitation event:

Capnography and Airway Monitoring

Use end-tidal CO₂ (ETCO₂) monitoring to ensure ventilation is supporting effective gas exchange.

Visual Cues and Breath Volume

Watch for visible chest rise and avoid delivering excessive volume with each breath. One breath over 1 second, just enough to make the chest rise, is sufficient. Over-inflation increases the risk of barotrauma and gastric inflation.

Proper Mask Seal and Air Delivery

Ensure a tight seal with the bag-valve-mask to direct air into the lungs, not the stomach. Poor technique can lead to air leaks or air entering the GI tract, both of which compromise effective ventilation.

Clear Communication During a Code

Assign one person to manage ventilation and ensure everyone is aware of the ventilation rate. Verbal cues like “one breath every six seconds” help maintain consistency and prevent accidental over-ventilation.

Assign the Task to the Most Trained Rescuer

Ventilation should be handled by the most experienced team member, especially in high-pressure code situations. Skilled airway management is critical to avoiding preventable complications.

Emphasis on ACLS Training

Ongoing ACLS training and simulation practice reinforce correct technique and build muscle memory.

Systematic Patient Assessment

Resuscitation is followed by a critical phase of ongoing patient assessment and stabilization. ACLS-trained providers must conduct both primary and secondary evaluations to identify immediate threats and manage post-arrest care effectively.

The primary assessment focuses on the ABCs (airway, breathing, and circulation) along with neurologic status and exposure. It ensures that the patient has a protected airway, adequate ventilation and perfusion, and no immediate life-threatening injuries. During resuscitation, this step also includes establishing vascular access and identifying shockable rhythms.

Once ROSC is achieved, a secondary assessment begins. This involves a more detailed evaluation of the patient’s history, possible causes of arrest, and targeted interventions to improve long-term outcomes.

Post-Defibrillation and Respiratory Arrest Management in ACLS

During Defibrillation

Minimize CPR interruptions to under 10 seconds for rhythm checks or shock delivery.
Clear the patient and remove any oxygen sources from the chest before pressing “Shock.”
Follow AED prompts and resume compressions immediately after rhythm analysis.

After Defibrillation

Restart CPR right away, regardless of whether a shock was delivered.
Monitor ETCO₂—a value under 10 mmHg may indicate poor perfusion; improve compressions or consider vasopressors.
Reassess rhythm every 2 minutes.
Consider termination if no ROSC after 20 minutes of high-quality CPR in an intubated patient.

Certification & Training

Excessive ventilation is one of the most common mistakes made during resuscitation and one of the most avoidable. The key to prevention lies in training, practice, and up-to-date certification.

AMC’s 100% online ACLS certification and recertification courses are designed for healthcare professionals who want clinically rigorous training without the hassle of in-person classes. Whether you’re a nurse, paramedic, physician assistant, or other clinical provider, AMC’s ACLS training gives you the tools you need to master high-stakes decision-making—like proper respiratory ventilation techniques—under pressure.

Precision Saves Lives

Excessive ventilation during ACLS can undo even the most effective chest compressions and defibrillation efforts. The dangers are real and preventable with proper ventilation technique. These lifesaving skills require mastering breath rate, volume, and timing. With precision, discipline, and clinical excellence, every breath becomes a step toward your patient’s recovery.

If you’re ready to strengthen your skills and stay current with the latest ACLS protocols, AMC’s 100% online certification and recertification courses offer the flexibility, speed, and clinical accuracy you need. Get started on your ACLS training today.

About Greta

Greta is a dedicated life saver and a distinguished expert in the field of medical content creation and editing. Her impressive array of certifications in ACLS, CPR, PALS, and BLS underscores her commitment to excellence in the medical field. With over four years of invaluable experience in medical education, Greta plays an indispensable role within the Advanced Medical Certification team, shaping the way healthcare professionals around the world acquire and apply vital knowledge.

Greta's profound expertise serves as the driving force behind the development and distribution of medical content that has significantly enhanced the capabilities of countless healthcare practitioners across the globe.

In addition to her medical qualifications, Greta holds a prestigious academic distinction in Marketing and Global Business from Vilnius University. Her academic journey has been enriched by immersive studies in Slovakia and Portugal during her time as an exchange student, providing her with a global perspective that complements her medical expertise.

Beyond her professional commitments, Greta possesses a genuine passion for global exploration, with a particular focus on immersing herself in diverse cultures and appreciating the intricacies of the natural world. While residing in Vilnius, Lithuania, she continues to make substantial contributions to the field of medical education, leaving an indelible mark on the sector.

Reach out to Greta at greta.kviklyte@advmedcert.com.

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Top 10 Basic First Aid Skills You Should Know in The Office

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Mar 11, 2025, at 7:00 am

Anyone can be in a situation where an emergency happens, including at your place of work. If you are working and your coworker has a medical emergency, would you know what steps to take to help them? With basic first aid skills, you could make a difference in their life, and it may even help you to handle your emergencies should they happen.

Basic Life Support education is nothing to take for granted. If you are not yet certified, now is the ideal time to get these basic first aid skills. You can take an online course for basic first aid training right now and feel better about your ability to help when there is a medical emergency.

We offer Online CPR and BLS Certification

The following are 10 basic first aid skills most people should have. These are skills that you can apply to various situations that occur in the office (or any place of work).

#1: First Aid Basics

Before any life-saving care can be provided, you must be able to properly assess the situation to know what type of basic first aid to apply to a person in need. To do this, you’ll need to focus on the ABCs of first aid:

Airway: If someone is unconscious or unresponsive to you, your first step is to open their airway to give them the ability to breathe.
Breathing: If they are not breathing after you have adjusted their head to open the airway, the next step is to give them rescue breathing.
Circulation: Once you begin rescue breathing, you must perform chest compressions if the person does not have a pulse. This helps circulate blood to the rest of the body if the heart stops.

In most emergency situations, start with these three areas. Note that you will also need to contact 911 immediately or have someone else do so. Provide breathing and circulation support until emergency medical care is available.

You can learn the basic first aid skills for these steps here and on our blog. However, taking a course to learn the critical skills of CPR, AED, and First Aid is very important. You can complete this course quickly and have the skills necessary to protect someone’s life.

#2: Basic First Aid for a Stopped Heart

A woman touching her chest When a person’s heart stops beating, oxygen cannot get to the brain and other organs. While you wait for medical help to arrive, cardiopulmonary resuscitation (CPR) is the most important step for you to take. The following are the basic steps of CPR:

Call 911 or have a person nearby do so.
Do chest compressions. To do this, use both of your hands, in a ball, to push down hard and fast on a person’s chest. You will place your hands on the center of the chest. Press down with both hands and allow the chest to rise before repeating.
Continue to do this at a rate of 100 to 120 times per minute.

If you are trained in rescue breathing or CPR, you can provide rescue breathing as well. Because this is challenging to do on your own, have someone nearby help if possible. During rescue breathing, you’ll feel for a pulse and breathing. If there is not one, provide two quick breaths through the person’s nose and mouth. Then, start CPR. Complete 30 compressions and then breathe again.

If you have training and an AED is available, you can use it to help restart the function of the heart. Most AEDs have some basic information on how to use them, but you need training or the ability to follow those directions.

#3: Basic First Aid Skills for Bleeding

Accidents in the office may lead to substantial bleeding, and immediate action is critical to minimize the risks to the individual. In these situations, start with the same process of assessing their condition. Then, consider what is bleeding.

Capillaries are the smallest blood vessels, and as such, the blood flow is limited, and the bleeding will stop on its own within a few minutes.
Veins are larger and typically have a dark red color of blood. The bleeding may be significant or moderate, and benefits from some level of treatment from a rescuer.
The third type is arteries, which are the largest vessels and supply oxygen to the rest of the body. Bright red blood spurting out typically means a critical situation with significant blood loss.

In situations of severe bleeding, contact 911 as a first step. Then, follow these steps for basic life support care:

Wear gloves when possible. If possible, pour water over the wound or allow it to sit under running water for several seconds to cleanse it.
Cover the opening with clean gauze or a cloth. You can use clothing if nothing else is available. Wrap it tightly.
While you wrap it, apply pressure to the area where the blood is coming from. Continue to apply pressure after it is wrapped, which will help a clot to form.
When possible, position the wound above the level of the heart. This makes it harder for the blood to flow out.
Keep applying additional layers of cloth to the wound – never remove what is already there. Keep pressure on it until help arrives.

If the wound is significant, a person may pass out. Be sure to consider the ABCs of providing basic first aid to the individual throughout this process. Follow the BLS algorithm to ensure you’re taking active steps in protecting the life of your team.

#4: Basic First Aid for Broken Bones

a doctor is touching her left back as she experiences pain A person falls and lands on their arm. That could mean there’s a risk of a broken bone. Note that fractures may protrude from the skin, or they may not. Signs of a break include:

Loss of movement and control over the limb
Significant pain
Swelling
The bone is oddly shaped, or the overall alignment of the bone is no longer normal

If you suspect a person has a broken bone, it is necessary to get them to the emergency room for the proper alignment and placement to encourage healing. However, there are several things you can do in the meantime to minimize further risks:

Keep the limb immobile. Do not try to move it.
When possible, use a sling to hold the injured area against the body to prevent worsening.
If the skin is broken and the bone is protruding, cover it with a clean cloth before transporting it.

#5: First Aid For Burns

Another of the most important basic first aid skills every office employee should have is effective treatment for burns. A burn can worsen without quick action, and the pain can be substantial. Whether a burn occurs from a fire or from a piece of equipment that fails to operate properly, consider the following first aid basics.

First, know the risks of burns. They can happen in various ways, such as due to chemicals used for cleaning or electrical burns from an outlet. Whatever is occurring, stop that first, such as turning off electricity or rinsing away the chemical from the skin.

Then, follow these tips for the treatment of serious burns:

Clean the area by using running water over the surface. Keep the temperature cool. Avoid the use of ice, but allow cool water to run over the surface for several minutes.
Apply a gauze bandage loosely over the top of the burn. Do not apply too much pressure as it can worsen the pain.
Do not apply medications or ointments while providing first aid.
Avoid breaking any blisters or peeling off the skin.

911 is a critical service to call for third-degree burns. Even if the burns are second-degree, with blistering, you’ll still need to get them to an urgent care center for treatment. The risk of infection is very high.

Follow CRP algorithms to ensure you take steps to immediately help a person who is not breathing. Do not wait to get help in these situations.

#6: Basic First Aid for Sprains

Sprains occur when damage to the tendons, ligaments, or muscles occurs. The goal of first aid here is to support the sprain to allow for healing. If a person cannot walk, it may be necessary to call 911. In other situations, consider the following steps:

Rest: Get them off their feet and sit down for a bit to allow for the inflammation to reduce.
Ice: Apply ice to the area where the pain radiates. This also helps control pain and reduce inflammation.
Compression: Apply compression to the area with a bandage to keep the swelling down.
Elevate: Bring the body part up over the elevation of the heart.

If the pain does not improve, you can continue to ice the area every hour for about 15 minutes at a time.

#7: Basic First Aid Skills for Nosebleeds

A nosebleed can be more challenging than other bleeding because the area impacted is difficult to reach. If a person has a nosebleed that is not from trauma (such as falling and striking their face), follow these steps:

Lean the head forward slightly, bringing the chin closer to the chest.
Apply a clean cloth to the nose and pinch the bridge. Do not pinch the nostrils but the area above this.
Hold this for several minutes. Then, check to see if the bleeding has stopped. If not, repeat this and continue for another 10 minutes before checking again.

In the case of trauma to the head, it’s necessary to assess what occurred and if the person is breathing. Perform CPR as appropriate. Most of the time, trauma to the nose will cause substantial loss of blood. Follow the steps above to stop the bleeding, but plan to head to the emergency room.

#8: Basic First Aid Skills for Choking

an unconscious man lying on the floor A person who is choking cannot breathe and needs immediate medical care. They may be gasping for air, wheezing, or looking panicked. It is very common for a person to be unable to speak and may become blue within a few minutes.

In this situation, apply the Heimlich maneuver following these steps:

Stand behind the person and encourage them to lean forward slightly.
Place your arms around their waist so that your hands meet in front of them.
Create a ball with your hands and your thumbs inward against the wall of the chest. Position your hands between the belly button and the rib case.
Grab your fist with your other hand and then apply a significant thrust in an upward movement. Pull backward and upward with your first. Do this five times.
Repeat until the object is coughed up.

When you consider Basic Life Support testing, you’ll learn more about what to do if a person passes out from choking.

#9: Basic First Aid for Frostbite

If your team is working outdoors and someone has pain radiating from exposed skin, they could have frostbite. After getting into the enclosed area, run the area under warm water—avoid hot water. Do this for 20 to 30 minutes, allowing a warm stream of water to run over the area.

Avoid irritation or rubbing of the skin, as this can cause pain and damage. Do not place the area by a heater or any source of significant heat, as this can lead to serious burns. Fireplaces and heating pads are not advisable. If there is pain after 20 minutes, wrap the area with bandages loosely and give it time to heal without additional cold exposure.

#10: Basic First Aid Skills for Allergic Reactions

One of the more complex aspects of first aid training is knowing how to help someone who has an allergic reaction. Food, chemicals, bees, or other types of allergies are not uncommon. Most of the time, a person with a severe allergy will have an auto-injector available to provide epinephrine to reverse the symptoms.

Suppose they do not have this or know of an allergy, your reaction time matters. If a person is struggling to breathe or has a swelling face, it is critical to call 911 and then help them to rest. Keep the airway open.

If the allergen is caused by exposure, such as touching or breathing it in, move out of the space where there is fresh air and wait for help to arrive. Because allergic reactions can be life-threatening, make sure you practice your CPR skills.

Basic First Aid Skills in the Office Save Lives

Having these skills, along with a full first aid kit, can help you be prepared for anything that happens in the office.

Don’t stop there. Get the education you need to make a difference. The BLS Online Certification is a fast and easy course you can take to learn critical, life-saving skills.

You can also build your skills and knowledge by exploring our Journal Articles. Education is one of the most important (and powerful) tools you have when it comes to basic first-aid training. Reach out to Advanced Medical Certification for the help you need to protect the lives of others.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

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How to Perform a Head Tilt Chin Lift Maneuver? A Step-by-Step Guide

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Jan 31, 2025, at 5:00 am

In emergency medical situations it is critical to effectively manage a patient’s airway and ensure it remains unobstructed. Patients need to be treated quickly to reduce the risk of suffocation, brain damage, and other serious complications.

One of the fundamental techniques used by first responders and other healthcare providers in these instances is the head tilt chin lift maneuver. This simple but vital procedure can save lives by opening a patient’s airway.

Here is what you need to know about this procedure’s importance, step-by-step implementation, indications and contraindications, associated risks, and role in emergency care scenarios.

We offer Online CPR and BLS Certification

A Tilted Head Opens the Airway

An airway obstruction can happen when a person’s tongue or other soft tissues block airflow into the lungs. In an unconscious person, the muscles relax more fully than they would in someone awake or even deeply asleep. This heightened level of relaxation and diminished muscle tone causes the tongue to fall back and obstruct the airway.

Naturally, this is an issue that needs immediate correction to prevent a host of different problems that can have significant, long-term consequences. The head tilt chin lift position counteracts airway obstruction and makes it easier for medical professionals to get air into a person’s lungs. Seconds count, so the goal is to use the fastest and most accurate procedure based on the unconscious person’s needs.
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The Importance of the Head Tilt Chin Lift Maneuver

While there are other ways to handle airway management in an unresponsive patient, the head tilt chin lift position is considered the gold standard. It helps clear the airway by:

Moving the tongue away from the back of the throat
Allowing for effective ventilation during rescue breathing
Aligning the oral and pharyngeal axes

When giving breaths to an adult use the head-tilt/chin-lift technique to open the airway unless there is a specific reason you cannot (such as a spinal injury). Unlike options that use more complex airway devices, there is no specialized equipment required for this technique. It can be learned and used by medical professionals and laypersons without additional medical training.

When to Use the Head Tilt Chin Lift Position

A person practicing head tilt chin lift maneuver with a mannequin There are several scenarios where this procedure is the best choice. These include:

Unconscious patients without suspected spinal injuries
Basic Life Support (BLS) and Cardiopulmonary resuscitation Life Support (CPR)
Cardiac arrest situations where an airway needs established
Patients experiencing airway obstruction due to tongue relaxation

These are the main situations where a properly tilted head can create an airway. However, there are also times when this procedure either will not be effective or could cause harm. It is essential to know when not to use the head tilt chin lift maneuver.

When to Avoid the Head Tilt Chin Lift

While the head tilt chin lift is a highly effective way of opening an airway in an unconscious patient, there is another method of opening the airway with a suspected neck injury. If you have any suspicion that the patient may have a spinal injury, choose the jaw thrust maneuver vs head tilt-chin lift.

This reduces the risk of exacerbating potential cervical spine injuries and creates an adequate airway for treatment. Any time there is the potential for a neck injury it is important to err on the side of caution. For patients without spinal injuries, though, the head tilt chin lift is the preferred airway management method.

Step-by-Step Procedure for the Head Tilt Chin Lift

Now that you know when to use this maneuver (and when not to), what steps should you follow to open the airway? How do you know if you are performing the maneuver correctly? While this is not a complicated procedure to perform, doing it correctly is important due to the vital nature of creating and maintaining an airway in an unconscious patient.

Here are clear, step-by-step instructions for everything you need to do.

Step 1: Get in the Right Position

To get into the proper position for this maneuver, you will want to either kneel beside the patient or position yourself near their head. You need to be able to easily reach their head and chin to have access to the area you need to adjust for airway management.

Step 2: Pay Close Attention to Hand Placement

Use one hand to put pressure on the patient’s forehead. With the other hand, place your fingers under the bony part of the chin. Once your hands are properly placed you can perform the maneuver safely and effectively.

Step 3: Tilt the Head While Lifting the Chin

Gently push down on the forehead while lifting the chin upward at the same time. This will move the tongue away from the back of the throat, so the airway stays open.

When giving breaths to an adult use the head-tilt/chin-lift technique neutral, or the head-tilt/chin-lift technique past neutral. In other words, you can tilt the head into a neutral position, but may also need to go past neutral to fully open the airway. For infants and very young children, you should stay in the neutral position, as going past neutral can restrict their airways.

Step 4: Check for Proper Alignment

The patient’s mouth should be slightly open. Their head should be in a neutral or slightly past neutral position to give them maximum airflow. You can adjust the head position between neutral and past neutral as needed, to ensure the patient is breathing as easily as possible.

Step 5: Check for Proper Breathing

There are several ways to check for breathing in an unconscious patient including observing chest movements, listening for breath sounds, and leaning in close to the patient to feel for breath on your cheek.

Step 6: Provide Rescue Breathing if Needed

If a patient is not breathing on their own you should begin rescue breathing or proceed with CPR as the situation requires. The specifics of the patient and their needs will affect the additional measures taken.

Practical Tips for Effective Care

Airway management is essential when an unconscious person has an airway obstruction and cannot breathe clearly on their own. However, the head tilt chin lift is not without risk. To minimize the chances of causing injury during this procedure, there are some practical tips to follow. These include:

Using minimal force to avoid causing jaw or neck injuries.
Avoiding excessive backward tilting of the head, which can actually compromise the airway instead of opening it.
Monitoring the patient continuously to ensure the airway remains clear.

During stressful situations, adequate training can help reduce injury risk and make the right treatment options more instinctual. The goal is to act quickly and with skill in order to maximize a patient’s chances of survival and lower the chances of significant or long-term injury.

The Role in Cardiopulmonary Resuscitation

Using the head tilt chin lift position is critical during CPR. First, it helps to establish a patient airway during the initial assessment of an unresponsive patient. Second, it is part of the “airway” component of the “ABC” sequence (Airway, Breathing, Circulation). Lastly, when combined with rescue breaths it ensures that the patient will receive oxygen until advanced airway management is available.

Risks and Complications

The head tilt chin lift is generally considered safe for most people. However, there are some risks to consider. Understanding how the procedure could cause harm is the first step in reducing the chances of injuring a patient while establishing an airway. The primary risks of this maneuver are:

Neck injury through improper technique or too much force.
Jaw or facial pain through excessive force and soft tissue injury.
Inadequate airway clearance due to failure to maintain the correct position.

Fortunately, these risks and avoidable with practice and the proper technique. Knowing how much force to apply and when to consider the jaw thrust maneuver vs head tilt-chin lift are critical components of successfully treating an unconscious patient with an airway obstruction.

Comparing the Jaw Thrust Maneuver vs Head Tilt-Chin Lift

unconscious man lying on the ground and a rescuer doing head tit chin lift maneuver Understanding the main differences between the head tilt chin lift and jaw thrust maneuver is vital to knowing when to use each one. The goal is to be as effective as possible while reducing the risk of harm, and knowing is a powerful way to do that.

Use the head tilt chin lift for non-traumatic airway management. It is simple and widely used but is potentially unsafe for spinal injury patients. If your patient has a suspected spinal injury, choose the jaw thrust maneuver. While this method of maintaining an airway requires more skill, it is the procedure of choice for suspected cervical spine injuries.

Practice and Train to Increase Safety and Effectiveness

Mastering life-saving procedures like maintaining an airway in an unconscious patient requires regular training and practice. The right course and certification programs go a long way toward learning everything you need to know. That can help you stay up-to-date on all the best ways to help and protect patients and give you confidence in your abilities when you need to use these techniques.

Online courses are an option to begin training or to renew or add to your certifications as a medical professional. These courses can also help laypersons learn first aid, CPR, and other essential skills for emergencies. For most online courses you can expect to:

Review the online materials for your certification.
Watch the skills videos to understand the procedures and techniques discussed.
Take (and pass) an exam to provide proof of your certification.

While there are still some types of classes and certifications that need to be done in person, online training can significantly enhance the knowledge and skills needed in medical settings. You can also practice with others in a hands-on environment to ensure you are comfortable with specifics such as hand placement and the right amount of tilt to maximize the airway opening.

The Head Tilt Chin Lift Maneuver Is a Life-Saving Technique

This procedure is a cornerstone of basic airway management because it is simple, effective, and accessible to nearly everyone. That makes it a critical part of emergency care and a way to save lives. Whether it is performed by a healthcare professional or a layperson who responds to an unconscious person, knowing how to do this maneuver safely can make the difference between life and death for a person needing help to breathe.

This crucial skill is one that every medical professional should have, and staying aware of any updates to the technique or its use cases helps reduce risk and improves the chances for patients who need this type of care. With regular training, an understanding of when to use this method and when to avoid it, and a focus on the proper technique it is possible to maximize the life-saving potential of this position.

Frequently Asked Questions

Can the head tilt-chin lift procedure be used on infants?

Yes, this procedure can be used on infants, toddlers, and young children. However, taking additional care and a gentler approach is very important when helping babies and children. They are more flexible and delicate than an adult, and that makes it possible for them to be injured during the maneuver. The best way to reduce the risk of injury is to make sure to tilt their head back only slightly since an excessive tilt can obstruct their airway instead of opening it.

What should I do if I suspect a spinal injury?

If you suspect that a patient has a spinal injury it is best to choose the jaw thrust maneuver vs head tilt-chin lift technique to maintain the airway while minimizing spinal movement. While it is vital to open an airway for any patient with an obstruction in that area, you also want to lower the risk of causing or contributing to the risk of paralysis or other serious spine health problems.

How do I know if the airway is open after performing the head tilt chin lift?

After performing this maneuver you will want to observe the patient’s chest for movement, listen for their breath sounds, or feel for air movement on your cheek by leaning in close to them. If the patient is not breathing, rescue breaths should be given. You may also need to start CPR, depending on the patient’s condition and the presence of vital signs.

Take the first step in saving lives. Enroll in our BLS or CPR certification courses to gain the skills you need for emergencies. Start your journey with Advanced Medical Certification today!

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

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BLS vs CPR: Which Certification is Right for You?

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Dec 24, 2024, at 4:50 am

Saving a life requires swift action. Having those skills requires completing the necessary training and practicing. There are various ways to do that, including two common strategies: Basic Life Support (BLS) and Cardiopulmonary Resuscitation (CPR). What is the difference between BLS vs CPR?

This guide explores the differences between CPR and BLS, helping you decide which is better suited for your needs and the skills you aim to develop.

You do not have to have a certification to be competent in either of these areas. However, certifications are valuable. Employers may require them. They also help demonstrate your knowledge of specific skills, especially if you plan to volunteer.

We offer Online CPR and BLS Certification

CPR vs BLS: The Differences

Both of these methods teach you how to react to potentially save the life of a person who needs immediate help. However, there are distinct differences between the two.

CPR is a technique that helps manually pump blood to a victim’s vital organs when they are not breathing. It also pushes air into the lungs when there is no breathing movement. CPR courses will teach you specifically how to help a person facing Sudden Cardiac Arrest (SCA) in a non-medical setting.

CPR equips rescuers with the knowledge and tools needed to act immediately in non-medical settings, providing aid until emergency responders arrive. Here are some details of what CPR Involves:

It applies in situations where the injured person’s heart has stopped working or they are not breathing.
It involves blowing air into the mouth to force oxygen into the body while also applying chest compressions that force blood to move through the heart.

CPR significantly increases the chances of a person’s heart restarting once defibrillation or other life-saving methods are used.

Basic life support (BLS) is much like CPR and includes CPR. However, it provides a higher level of medical care administered by a public safety professional. Typically, BLS is administered by trained paramedics, healthcare workers, first responders, or public safety professionals like police officers. However, bystanders can provide this type of life-saving effort as long as they have proper training.

Here are a few key factors to consider about BLS:

It provides those who are in respiratory distress or cardiac arrest support until more advanced care is available in a hospital setting.
BLS involves initial assessment, airway maintenance, and then CPR

The biggest difference between the two is the level of experience and training. BLS ensures that the person providing this type of care has enough medical knowledge and experience to assess the patient’s needs properly and promptly, allowing proper care to be applied.

Though it is typically geared toward medical professionals, it can also be incredibly beneficial for caregivers of people with pre-existing medical conditions and for those with some level of medical knowledge who wish to learn more about more advanced life-saving measures.

Specific Differences in BLS vs CPR

Group of men and women practicing cpr compressions using a mannequin When you consider BLS vs CPR one of the most important factors to remember is that both are life-saving, valuable, and worth learning.

CPR is ideal for anyone who wants to learn basic life-saving skills. It can be applied to adults as well as children. It is typically a valuable tool in situations where cardiac emergencies can occur.

BLS is more comprehensive. It includes CPR. However, it also offers more advanced education and training based on the assessment the rescuer provides to the patient. BLS provides everything that CPR includes, but it goes further. It provides additional support by including care strategies for those who are suffering from not only cardiac failure but also respiratory distress or airway obstruction.

Specific BLS vs CPR Course Differences

BLS vs CPR certification is also different. As expected, BLS goes further and provides more medical-first applications of life-saving strategies. It includes additional life-saving techniques.

With BLS vs CPR, consider the differences in these courses:

CPR and AED courses are an important part of initial training and education. They also meet the very basic requirements for OSHA-mandated first-aid training and CPR training. CPR training is the foundation and starting point for those who are responsible for improving workplace safety. It applies to virtually any work environment.
BLS courses go further, providing more advanced knowledge and training to those who will likely use its strategies over time. They include competency verification, education, and credentials that are often necessary for healthcare professionals. This includes the emergency room and hospital care necessary for those who work in acute-care settings.

BLS vs CPR: Which One Should You Choose?

CPR vs BLS certification is a careful decision. Some people do not need more in-depth life-saving skills. They do not work in a high-risk area.

Comparatively, those who are in a post-acute care setting or hospital are more likely to need to apply life-saving measures. That makes BLS training more important.

To determine which strategy is right for you, consider the following:

What type of work do you currently do?
Do you work with medically fragile people?
Is there someone in your home who is medically fragile with a risk of suffering a heart and respiratory event?
Does your employer require one or the other: BLS vs CPR, or does the employer recommend both training?
Do you provide services, such as a fitness trainer or therapist, to people who could experience more life-threatening conditions?

CPR vs BLS decisions can be difficult in some situations. However, know that BLS goes further, covers more, and provides you with a higher level of skill to handle difficult situations in a meaningful and safe way. Keep in mind, though, that BLS vs CPR certification is different. You will need to have more initial medical skills heading into BLS than you do with CPR training.

What Goes Into CPR Certification?

CPR certification aims to revive a person who is not breathing or whose heart has stopped. It uses several strategies, including chest compressions and rescue breaths, to facilitate life-saving measures.

The objective of CPR certification is to maintain blood flow as well as oxygen through the body to keep vital organs from shutting down. It is meant to be a stop-gap until more help arrives.

When you complete a CPR certification course, you will learn:

How to perform chest compressions, including the proper technique, hand placement, depth, and rate of chest compressions to provide critical and life-saving support to a person in need
How to provide rescue breaths, including understanding when and how to administer such breaths, as well as how to properly ventilate the respiratory airway
Automated external defibrillator (AED) use, including how to operate an AED and when to do so, since an AED increases the chances of success in saving a person’s life.
First aid skill training, including basic principles, such as wound care and reduction of bleeding, as well as how to recognize the signs of a heart attack, stroke, and other conditions
Legal and ethical considerations related to providing care, including the obligations of providing CPR in a manner desired and beneficial to the patient.

CPR certification online is an option. You can also obtain it through other in-person courses.

CPR is best for:

Non-healthcare workers
Teachers
Office workers
People who work in supportive services in medical facilities
Those who provide day-to-day care for others
Childcare providers
Lifeguards

CPR is recommended for anyone who wants to be ready to protect another person’s life.

What Goes Into BLS Certification?

As you think about BLS vs CPR, you also need to consider the importance of more advanced care. It is a more advanced type of training program. It is more challenging to learn, especially for a person who may not have a lot of education in the medical field.

BLS certification is ideal for those who need or will likely use life-saving measures during their course of work. Consider BLS certification vs CPR.

In a BLS course, you will likely learn:

CPR for health care providers involves more in-depth training on chest compression application, rescue breathing, and advanced airway management methods and recommendations.
Team dynamics, including how to communicate and coordinate care for a person who needs life-saving measures meaningfully during resuscitation efforts.
The use of a bag-valve-mask (BVM) device includes when and how to use these devices to improve ventilation for a person who is not breathing on their own, including how to use a BVM device.
Pediatric-specific care for a patient, including the differences between CPR and resuscitation on infants and young children compared to those for adults, including rescue breaths for children.
Use of an AED, including how to operate the AED with more refined skills to apply various types and levels of care in the appropriate setting for the patient.

BLS certification courses are available online. They take a bit longer to complete because they offer more in-depth education and training for the individual.

BLS training is best for:

Emergency medical care providers
Hospital workers
Doctors
Paramedics
First responders
Nurses
Those working in nursing homes or rehabilitation facilities
Individuals who have critical risk patients they provide care to

BLS vs CPR decisions are important, but it helps to know how important having either of these is. If you are unable to obtain a BLS course for any reason, having CPR training is nearly always beneficial.

Consider the following details to provide a bit more insight into BLS certification. It is a two-year certification program. It will meet the competency requirements for education, credentialing, and privileging set by most employers and others.

How to Obtain BLS vs CPR Education

paramedic student learning cpr You have decided to obtain the BLS certification vs CPR. How do you get started? You can get the help you need right here at Advanced Medical Certification.

The BLS online certification program provides you with up to 4 AMA Category 1 credits.
It includes ILCOR standards and guidelines, Joint Commission compliance, and hands-on support.
You will receive a BLS online handbook that will give you all of the details of how to complete the program.

This course is designed by Board Certified Physicians. It teaches high-quality, effective, and detailed information. Remember, it meets all of the ILCOR Standards and Guidelines, which means it typically meets all requirements for workforce training that may apply to anyone who needs CPR training or more advanced care.

You can complete CPR education online with us as well. If you are considering this program, there are a few key things you should know:

With CPR, AED, and First Aid Certification available through our online educational program, you will be able to achieve 6 Category 2 CME credits.
You will learn both child and Infant CPR alongside adult-specific care.
You gain the necessary skills to provide life-saving support to individuals who need it.

The Importance of BLS vs CPR

For those who are ready to learn the steps necessary to care for a person who is facing life-threatening medical events, BLS vs CPR is a critical decision. Both options are beneficial.

Certification plays a vital role in improving survival rates in any situation in which a person is not breathing or their heart has stopped. With this type of training, you gain the ability to help save a person’s life. If you are not sure if you should choose either program, consider the following benefits that can come from having this type of education:

You can provide immediate response to a person in a life-threatening condition. Certified individuals in either CPR or BLS will be able to react to reduce the amount of time the lapses between not getting oxygen to the brain and receiving more advanced care.
Increased survival rates apply in both BLS vs CPR settings. In all situations, having the knowledge necessary to do something – and do it properly – can be life-saving.
Professional competence requirements are met typically with BLS training for those in a health care setting.

Learn more about how BLS vs CPR applies in your specific situation. In both situations, having training saves lives and is well worth obtaining for anyone.

BLS Vs CPR: Where to Get Started

With BLS certification vs. CPR certification an option for you or in-depth, high-quality BLS training available, Advanced Medical Certification provides you with the ability to achieve the skills you need to save a person’s life. Learn more about our programs and how you can get certified online. Turn to us with any questions you may have on the right type of program for your needs.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

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ACLS vs. ALS

Learn More About PALS Certification

ACLS vs. CPR

Rescue Breaths for Child: Pediatric BLS Algorithm Guide

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Nov 29, 2024, at 7:00 am

Basic Life Support (BLS) is critical for rescuers to understand, including how to provide rescue breaths for a child. The difference in anatomy and risks faced by a child are different than adults. Knowing the specific best practices for pediatric BLS can make an incredible difference in protecting the life of a child.

The First Step: Knowing How to Provide Rescue Breaths for Child

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As a rescuer, it is critical to know what to do and what order to do so in order to provide a child with the life-saving support they need. Consider the following strategies:

Initial Support

Ensure the scene is safe. Protecting yourself is always the first priority.
Should for help nearby.
Activate any available emergency response system, such as using a mobile phone to dispatch emergency care, following facility protocol, or other required first steps based on location.

In situations where a child falls to the ground and stops responding, and you see that happen, call for an emergency response first and then get an AED to use prior to providing CPR.

If you did not see what occurred and just found the child on the ground, provide CPR for 2 minutes. Then, leave the child and call for emergency response.

In either situation, obtain an AED or other available emergency equipment or send someone else to get it. Then, assess the child for breathing and pulse.

Depending on what you find, consider the following strategies.

Normal Breathing and a Pulse: In this situation, you can definitely feel the heartbeat and see the chest rising and falling. Monitor those circumstances until more help arrives.
No Breathing with a Pulse: If the child is not breathing or is only gasping for air, complete the following steps:
- Provide rescue breathing immediately, apply breath every 2 to 3 seconds, resulting in between 20 and 30 breaths a minute.
- If the pulse is less than 60 beats per minute, but there is poor perfusion of oxygen, start chest compressions at that time. This includes cool extremities, lack of responsiveness, weak pulse, mottling, cyanosis, or paleness.
- If the pulse is over 60 beats per minute, recheck the pulse every 2 minutes. If that changes to no pulse, follow the steps to provide pediatric CPR.
- After two minutes, activate emergency response if not doing so.
- In some situations of abnormal breathing like this, the child may have suffered an opioid overdose. If there is potential for this, consider the use of naloxone and then follow an opioid overdose protocol.
No Breathing and No Pulse: If the child is not breathing and there is no detectable pulse, follow these steps:
- Alone: If you are alone, start by providing high-quality cardiopulmonary resuscitation at a rate of 30 compressions to 2 breaths.
- Not alone: If you are not alone, start CPR at a rate of 15 compressions per 2 breaths, splitting the task with the other person.
- 2 minutes: Every two minutes, check the pulse and heartbeat. Then, switch out who is engaging in the compressors.
- Use AED: Once an AED is available, follow the prompts provided by the device. If there is a shockable rhythm, defibrillate and then restart CPR. If there is not a shockable rhythm, resume CPR for 2 additional minutes and then reassess.

What Is High-Quality CPR for Children?

High-quality CPR can significantly improve a child’s ability to survive a wide range of conditions with the least defects. Studies reported in the National Library of Medicine indicate the quality of CPR can enhance outcomes for all patients. When providing rescue breaths for child patients, it is critical to provide the highest accuracy of care. Consider the following strategies to provide high-quality CPR when providing rescue breaths for child with pulse or without a pulse.

Chest recoil: Enable the chest to completely recoil after each compression before attempting another
Compression rate: Aim for 100 to 200 per minute when there is no pulse detected
Compression to ventilation: Aim for a ratio of 30:2 for a single rescuer, or 30 compressions for two breaths, or a rate of 15:2 if more than one rescuer is present
Continuous compressions: In situations where there is an advanced airway present and asynchronous ventilation, provide continuous compressions.
Rotate: Rotate out the compressor every two minutes or in any situation where one is fatigued.
Limit interruptions: Ideally, there should be no interruptions in compressions that are more than 10 seconds.
Avoid excessive ventilation: This can cause additional difficulties for patients and limit the overall success of compressions.

Compression Rates in Infants Under the Age of 1

CPR training on an infant mannequin Children who are very young or very small may require different support to help them start breathing properly. To provide rescue breaths for child care at this age, for any child that is under one year old, excluding newborns, follow these specific steps:

Use the brachial artery to check for a pulse.
Compression landmarks are different. The lower third of the sternum between the nipples is ideal.
Compression methods are also different. Use two fingers if alone or a thumb-encircling method if multiple providers are present.
Depth of compressions is also much smaller. Aim for at least one-third AP chest diameter. This is about 1.5 inches in most children.

Establishing an Airway

To be successful with rescue breaths for child patients, it is critical to establish an airway and ensure the child has the ability to breathe from a structural standpoint. To do this in a child, follow these steps:

Infants under the age of 1: Sniffing position.
Children over the age of 1: Head tilted and chin lifted position.
Trauma situations: If there is any suspected trauma to the child’s head or neck, limit any neck movement possible. Use the jaw thrust process without head tilt to provide care.

Breathing in Children

To provide rescue breaths for child patients, follow these guidelines:

Rescue breathing or compressions to ventilation: If there is 1 rescuer, a 30:2 ratio. If there are multiple rescuers: 15:2
Ventilation with advanced airway: In situations where there is a supraglottic airway or endotracheal tube present, follow these steps. Deliver one breath every 2 to 3 seconds, resulting in 20 to 30 breaths per minute. Use waveform capnography or capnometry whenever possible.
Notice the child’s chest: Ensure there is a rise in the child’s chest for each breath.

How and When to Defibrillate a Child for Rescue Breaths for Child

Rescuing breaths should always focus on the very best tools and resources available, and an AED may be applicable in many situations. However, there are specific guidelines to follow when attempting to use an AED on a child.

Use it now: As soon as the AED is available and the child does not have a pulse, use it to restore a heartbeat.
Dose attenuator and pads: Whenever possible, if a child is under the age of 8, use pediatric pads, especially in infants. However, if pediatric pads are not available, use adult pads (do not forgo applying AED treatment if the patient needs it)
Manual defibrillator: In infants, it is best to use manual defibrillators. This applies to children under the age of 1.
Adult defibrillators: These devices are not endorsed by most AED devices for use on a patient that has a shockable rhythm; however, doing so can provide life-saving support when there is a need to take immediate action. (It is critical for rescuers to know that it is not uncommon for infants to express VT and VF. This is not uncommon in infants. )
After Shock: After shocking the child, immediately begin CPR. Do this after each shock provided to the child. Provide CPR for at least two minutes before attempting another shock.
Limit interruptions: Avoid any type of interruption in chest compressions. This includes both before and after the shock occurs.

Rescue Breaths for Child with Pulse

In situations where the child has a pulse but is not breathing, there are several specific steps rescuers must take. Rescue breaths for a child should not be delayed. In these situations, follow this guidance:

Provide 1 breath every 2 to 3 seconds, resulting in 20 to 30 breaths per minute
With a pulse that is under 60 beats per minute, with signs of poor perfusion, start chest compressions at the same time.
If there is a pulse that is over 60 beats per minute, continue to child that pulse every 2 minutes while providing breaths every 2 to 3 seconds.

How Many Rescue Breaths for a Child?

In the ideal situation, you should provide:

1 breath for every 2 to 3 seconds.
Assess pulse rate no longer than 10 seconds.
Aim for 20 to 30 breaths each minute.
Apply chest compressions if the child does not have a heart rate of 60 beats per minute or higher.

Know the Signs of Cardiac Arrest in Children

Boy experiencing chest pain It is not as uncommon as many expect for a child to enter into cardiac arrest, warranting the need for rescue breaths for child patients. The Children’s Hospital of Philadelphia notes that over 2,000 children die each year from sudden cardiac arrest. That is about 3 to 5 percent of all deaths in children between the ages of 5 and 19 years of age.

The key to saving a child’s life is acting quickly. Knowing the signs of cardiac arrest in a child is a first step. They include:

Increasing chest pain when exercising, including running, playing, or otherwise engaged in activities
A racing heart
Fainting or a dizzy spell after engaging in physical activity
Change in ability to exercise
Shortness of breath during exercise that seems excessive or new
Excessive fatigue when exercising

In these situations, a child needs support immediately. In situations where a child’s heart stops, brain damage can begin to occur within just a few minutes since there is no oxygen flow to the brain. However, the use of proper rescue breaths for child victims can significantly increase their chance of survival especially when those incidents occur out of a hospital. By acting quickly, rescuers can save a child’s life.

Common Causes of Respiratory and Cardiac Failure in Children

Numerous factors can cause a child to stop breathing or their heart to stop beating. Every situation in which there is no pulse and no breathing requires immediate rescue care for the child. Some of the most common causes of this in children include:

Chocking on food, toys, or other items
Head trauma or another serious injury
Drowning, including not obvious drowning incidents, such as incidents when the child seems fine initially
Excessive bleeding
Suffocation
Poisoning
Electrical shock
Lung disease
Undiagnosed or untreated heart conditions

How to Learn to Provide Rescue Breaths for Child Victims

There are various ways to learn to provide basic life support to pediatric patients. Taking action to immediately care for a person at risk is critical. With advanced training and certification, you gain the ability to react quickly, potentially preserving the child’s life in doing so.

To achieve this, explore the Pediatric Advanced Life Support (PALS) courses offered at Advanced Medical Certification. When you do, you will learn exactly what to do, when to do so, and how to support your patient as you provide them with the specific care they need.

With PALS certification, you will learn a wide range of critical tools and methods to provide care for victims. This includes:

What PALS is and when to use it
How to perform PALS Basic Life Support
Pediatric Advanced Life Support Strategies
How to use resuscitation tools
What to do when there is respiratory distress or failure
How to handle various heart rhythms such as bradycardia and tachycardia
How to handle shock and cardiac arrest

With support and guidance for all aspects of pediatric care, you can be confident in your ability to meet the needs of a child in an emergency situation.

Who Should Take a PALS Certification?

Anyone who wants to be able to provide a child with emergency care should consider the value of PALS certification. That could include:

Licensed medical professionals, especially those who provide care to pediatric patients
Family members of children with noted concerns
Community members that engage with children frequently, such as teachers and coaches
Having this type of skill can be valuable to any provider of childcare, including grandparents, professional childcare providers, and friends and family

Mastering the PALS algorithm enables children to receive the very best care possible in some of the worst conditions. If you have not done so, enroll in PALS certification. You can complete our BLS online certification now to get started, or you can renew your PALS certification if you already have one. To find the care you need, turn to Advanced Medical Certification for Guidance.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

Keep reading

What Does Basic Life Support (BLS) Stand For?

ACLS vs. ALS

ACLS vs. CPR

VTACH vs VFIB: The Life-Threatening Arrhythmias You Need to Detect and Treat

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Oct 30, 2024, at 7:50 am

Vtach vs Vfib is a critical difference that any rescuer must understand. Both are types of abnormal heart rhythms, and both can be critical to treat rapidly to protect a person’s life. When either type of arrhythmia occurs, it means there are irregular electrical signals occurring in the lower chambers of the heart, called the ventricles. When this happens, the heart cannot pump normally, and that leads to a lack of blood flowing through the heart to the other organs.

Understanding the difference between Vtach vs Vfib enables rescuers to apply the proper treatment.

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Both forms require immediate attention, but the type of treatment may be different from a first responder’s point of view. In this overview of both V fib vs V tach, we break down the difference between both and what steps to take in each situation.
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What Is Ventricular Fibrillation?

ventricular fibrillation algorithm Ventricular fibrillation, or Vfib or VF, is an irregular, life-threatening cardiac arrhythmia that occurs in the ventricular myocardium. Instead of the coordinated contraction necessary, the ventricular myocardium experiences a high-frequency and disorganized excitation. The result of this is the heart’s inability to pump blood through the body effectively.

Data noted by Medscape shares that outside of a hospital setting, 65% to 85% of people in cardiac arrest will have VF identified as the initial irregular rhythm. It is critical to note that, within just minutes, if V fib is not treated, it leads to death.

Thanks to the more commonly available community-based emergency rescue systems, including automatic external defibrillators (AEDs), there is an increase in the number of people who survive V fib, yet it is still critical for treatment to be immediate to give a person a chance at living.

Symptoms of Ventricular Fibrillation

Symptoms of those facing ventricular fibrillation will be essential to see right away so that treatment is provided efficiently. Common initial symptoms include:

Lightheadedness or dizziness
Fatigue
Palpitations, feelings of fluttering or pounding in the chest
Fainting
Shortness of breath
Chest pain and pressure

In some people, there are no external symptoms. A person may experience no symptoms until they pass out because of the lack of blood flow to the brain, at which time the heart stops beating within a matter of minutes.

What Is Happening in the Heart with V Fib and How to Know

One of the steps you need to understand when considering Vtach vs Vfib is what is happening in the heart. In ventricular fibrillation, the lower chambers of the heart contract in an uncoordinated manner, leading to a lack of effective blood flow.

The only way to know for sure what is occurring is through an electrocardiogram. However, a rescuer can take action to determine what is occurring by simply listening or feeling for a heart rate. A person may:

Lose consciousness
May be unable to breathe or gasping for air
A heart rate that is uncoordinated, hard to find, or very fast

In V fib, the electrical signals in the heart are not functioning as they should. In a healthy rhythm, the electrical signals travel from the atria, or upper chambers of the heart, to the lower chambers of the heart. This causes the ventricles to contract, and that contraction pumps blood out into the body.

In V fib, the heart’s electrical impulses are uncoordinated, leading to irregular and rapid electrical signals, causing the heart to quiver instead of pumping.

Common Causes of VFib

Ventricular fibrillation can be caused by two common problems:

A malfunction of the electrical properties of the heart
A disruption in the supply of blood to the heart muscle

The dysfunction of the heartbeat creates the risk. Within the heart, the right upper chamber, or right atrium, is the sinus node, a group of cells that work as a pacemaker for the heart’s electrical signals. This starts each heartbeat. The electrical signals move across the atria, and as that happens, it contracts, allowing blood to flow. As the signals arrive at the atrioventricular (AV) node, they slow down, creating a short pause to allow the blood to fill the ventricles. The signals then pass to the ventricles, squeezing the lower chambers and pumping blood to the lungs.

Emergency Management and Treatment of Ventricular Fibrillation

For the layperson, calling 911 and performing CPR is critical to save a person’s life. For the emergency responder, it is critical to follow the cardiac arrest Vfib algorithm for treatment. This process involves:

Provide CPR, including establishing an airway, providing oxygen, and connecting monitors.
Evaluate the rhythm to determine Vfib is present.
Apply an AED device
Continue CPR for an additional 2 minutes
Check for heart rate, and if V fib continue care
Defibrillate a second time, followed by 2 minutes of CRP
If VF continues, utilize epinephrine 1 mg every 3 to 5 minutes
Utilize amiodaron or lidocaine for treatment
Provide post-cardiac arrest care or start the process over

What Is Ventricular Tachycardia?

electrocardiogram defibrillator monitoring machine Ventricular tachycardia, VT, or V tach, is an irregular heartbeat that occurs in the lower chambers of the heart. In most people, a healthy heart rate is between 60 and 100 times a minute at rest. In a person with ventricular tachycardia, the heart beats faster, generally at 100 beats or more per minute.

When the heart rate is too fast, it can cause limitations on the heart’s ability to pump enough blood to the rest of the body. This is because there is not enough blood filling the ventricle before the next contraction occurs. This can lead to a person passing out.

The body can sustain VT for some time, though not usually without difficulty. In some situations, V-tach is a life-threatening conditions, especially if it lasts for more than a few seconds. This is dependent on the speed of the heart. Sometimes, when the heart is in V-tach for too long, or at too fast of a rapid, this can cause all heart activity to stop, called sudden cardiac arrest.

Symptoms of Ventricular Tachycardia

In the initial moments of this condition, it is likely that a person will remain conscious, and depending on how long it occurs and the rate of speed, complications may continue. Most people will have symptoms such as:

Chest pain
Dizziness
Pounding heart rate, called palpitations
Lightheadedness
Shortness of breath

There are two key forms:

Nonsustained V-tach: This tends to stop within 30 seconds. These brief moments often do not cause symptoms.
Sustained V-tach: This lasts longer than 30 seconds and can lead to serious health complications without treatment.

A person who faints loses consciousness, or experiences cardiac arrest could be suffering from sustained Vtach.

Common Causes of V-tach

Most of the time, the common causes of Vtach occur when there is a malfunction in the heart’s electrical signaling processes. This causes the heart to beat too quickly. When the lower chambers cannot fill with enough blood or squeeze the heart effectively, this can lead to complications. Many factors can contribute to V-tach occurring, including:

Lack of blood flow to the heart muscle due to coronary artery disease
Any condition that causes scarring to the heart tissue, called structural heart disease
Side effects of medications
Prior heart attacks
Long QT syndrome and other birth defects
Changes in mineral levels, including potassium, sodium, calcium, and magnesium
Use of stimulant drugs, including methamphetamine and cocaine

Management and Treatment of V-Fib

As with any other heart irregularity, the only way to truly have a diagnosis of what is occurring is to utilize an electrocardiogram or halter monitor and to pick up the changes in heart rate over time. Other tests, including an echocardiogram, chest x-rays, cardiac MRI, or cardiac CT can also provide insight into any damage to the heart’s muscle that could be causing this to occur.

For the emergency responder or rescuer working to save a person’s life, the following steps are taken according to the cardiac arrest VTach algorithm:

Provide CPR, including establishing an airway, providing oxygen, and connecting monitors.
Evaluate the rhythm to determine V-tach is present.
Apply an AED device if so, defibrillate
Continue CPR for an additional 2 minutes
Check for heart rate, and if is still v tach continue care
Defibrillate a second time, followed by 2 minutes of CRP
If VT continues, utilize epinephrine 1 mg for every 3 to 5 minutes
Utilize amiodarone or lidocaine for treatment
Provide post-cardiac arrest if the person’s rhythm stabilizes or symptoms subside or start the process over

In all situations, a rapid heart rate needs to be treated quickly. Getting the person to the hospital so that emergency care can be provided is, nearly always critical to creating an opportunity for a person to survive.

What Is the Vtach vs VFib Difference?

Ventricular Tachycardia vs. Ventricular Fibrillation The difference between Vtach and Vfib has to do with the function of the heart.

What is ventricular tachycardia? It is an instance in which the heart rate is above 100 beats per minute, often sustained for longer than 30 seconds. The heart is pumping blood, but at a very rapid pace.
What is ventricular fibrillation? The heart is not pumping blood because it is not squeezing, but instead, it is quivering due to sustained irregular heartbeats, often very fast.

In Vtach vs Vfib, the main difference is that the ventricles in VF are not contracting properly but quivering instead. This makes it impossible for the heart to pump blood properly, causing sudden cardiac arrest and death. VT can be sustained for some time, but is detected when there are three or more consecutive beats of 100 beats per minute or more.

A ventricular tachycardia ECG will have a notable, controlled rhythm. A ventricular fibrillation ECG will have an uncoordinated, irregular heart rate.

Diagnostics with an ECG

Vtach vs Vfib ECG

In both types of ventricular arrhythmias benefit from an ECG. An electrocardiogram (ECG) provides a way for responders to tell the difference in a person’s heart rate. In comparing a Vtach vs Vfib ECG, consider the ventricular contractions. If they are uncoordinated, that is VF. By contrast, in a Vfib vs Vtach ECG, if the beaches are coordinated, but they are very fast, that is VT.

Frequently Asked Questions

What is idioventricular rhythm?

Another condition that may be detected is idioventricular rhythm, which is a heart rate detected in the ventricular that is less than 50 beats per minute with the absence of P waves and with a prolonged QRS interval.

What is monomorphic ventricular tachycardia?

Another type of irregular heart rate is monomorphic ventricular tachycardia , which happens when the lower chambers of the heart beat very dangerously fast. A person with MVT, as it is known, must be treated with synchronized direct current (DC) cardioversion immediately to save their life. This typically starts with a dose of 100 J. Any unstable polymorphic VT must be treated with defibrillation.

What is polymorphic Vtach vs Vfib?

A polymorphic Vtach vs Vfib difference can be difficult to detect initially. In polymorphic ventricular tachycardia, malignant ventricular tachyarrhythmia is present with changing QRS patterns. These may terminate spontaneously in some situations.

What is the ventricular tachycardia Vfib vs Vtach long-term treatment option?

When it comes to Vtach vs Vfib, one of the ways these conditions result in is the need for monitoring and medication. Most often, a cardioversion can be done to restore normal rhythm as a first step. From there, are likely to conduct studies to determine the underlying cause of the concern, such as a structural concern or abnormality. Treatment through ablation, the use of an internal defibrillator, and additional medication management may be initial treatment plans.

Learning How to Save a Person’s Life

If you are asking questions such as “What is tachycardia?” you or someone you know may be facing an increased risk of cardiac arrest. In those who have these conditions, treatment is critical, but the first step is getting them to the hospital for care.

Recognizing when ventricular arrhythmia is occurring is the first critical step, and often patients only have a matter of minutes for treatment to occur. That is why it is critical for anyone to have proper CPR training.

If you have not done so yet, now is the ideal time to complete your Basic Life Support (BLS) training or complete your ACLS certification. Doing so could mean you have the unique opportunity to save a person’s life.

You can learn more about the options available to you to obtain your education and certification, with fully online programs, at Advanced Medical Certification. Take the time to learn how you can save someone’s life. Obtain your education and training online and get certified.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

Keep reading

What Does Basic Life Support (BLS) Stand For?

ACLS vs. ALS

Learn More About PALS Certification

ACLS vs. CPR

Mastering the PALS Algorithm: A Quick Reference Cheat Sheet

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Sep 19, 2024, at 4:19 pm

Pediatric Advanced Life Support (PALS) is one of the most important life-saving strategies rescuers of all types should know. It allows for very specific and guided steps to address the life-threatening and emergent situations that can happen to children. Knowing the PALS algorithm for your situation enables a rescuer to use every second of their time to support that patient’s needs.

Nurses, doctors, EMS professionals, and anyone who needs to know how to handle a life-threatening situation with children should consider PALS Certification. The certification process will provide you with exceptional insight and guided demonstrations on when, how, and what to do in the event of a pediatric emergency situation.

We offer Online PALS Certification and Renewal

Take our PALS Practice Test

One of the most important factors to know is that the PALS algorithm changes depending on the circumstances. By understanding the PALS algorithm thoroughly, you develop the necessary skills to act fast when seconds matter the most. You will find several specific types of PALS algorithms used today, including those for very specific conditions. While ideally, professionals will know all of these algorithms, some of the most important to study include the following:

Within each of those links is the specific algorithm associated with each situation. The algorithm spells out exactly what steps to take to know exactly what you need to do to preserve a child’s life. It is nearly always wise to download and maintain copies of these PALS algorithm sheets, especially if you are a professional.

What is a PALS Algorithm?

The PALS algorithm is a systemic approach to providing pediatric life support. Utilizing this approach, a rescuer will follow one step after the next to evaluate a patient and then manage their specific needs based on what is most important to do.

Time matters when a patient’s life is at risk. Children are even more complicated than adults in that they cannot explain what is happening. When seconds matter so much, it is critical to have a step-by-step and reliable approach to follow to react quickly to the needs of your patient.

In short, the PALS algorithm cheat sheet – a list of easy-to-read and follow steps – makes diagnosing and providing life-sustaining care to a young patient easier and more methodical. Instead of having to think about what you are doing, you can just do it.

What Is the Pediatric Basic Life Support Algorithm?

One of the most important algorithms to understand is the PALS BLS algorithm. In nearly all situations, this is the basic, foundational level of taking action when a child is critically ill. To help you see how an algorithm works, consider the following:

In this situation, the BLS algorithm follows this pattern:

Evaluate the situation. If a patient is unresponsive and not breathing normally, follow the next step.
Activate the emergency response system and get an AED or defibrillator.
Assess pulse. At this point, if there is not a definite pulse felt within 10 seconds, you begin to do CPR at a rate of 15 compressions and then two breaths.
If after assessing the pulse there is a definite pulse, you would administer one breath every three seconds, add compressions if the pulse remains under 60 per minute with poor perfusion despite adequate oxygenation and ventilation. It also requires assessing the pulse every two minutes.

If you did not find a pulse and you are providing CPR at a rate of 15 compressions and two breaths, you’ll follow these steps:

AED and Defibrillator use
Assess for a shockable rhythm
If there is no shockable rhythm, resume CPR immediately for two minutes and continue this process every two minutes until more advanced help arrives.
If there is a shockable rhythm, administer one shock and resume CRP immediately for two minutes. They continue the same process of accessing the pulse.

It is important to know that this PALS algorithm does not eliminate the need for proper training and education. Be sure to consider the importance of purchasing and completing a PALS Certification.

PALS Bradycardia Algorithm

Another PALS algorithm process focuses on situations in which a patient shows signs of pediatric bradycardia with a pulse and poor perfusion. In this situation, a healthcare provider will need to move through a series of steps to provide the critically ill patient with the right type of care and treatment.

First, you will need to identify and treat any underlying cause present. To do that:

Maintain the airway and assist in breathing when it is necessary
If hypoxemic, administer oxygen to the patient
Use a cardiac monitor to identify the patient’s heart rhythm
Monitor both oxygen and blood pressure
IO/IV access installation
Assess a 12-lead ECG

With this information, if you find that the patient has persistent bradyarrhythmia, determine what the causes are. This may include hypotension, acute altered mental status, and signs of shock. If the patient has any of these signs, move through the following steps:

If the heart rate is under 60 beats per minute with poor perfusion despite providing oxygenation and ventilation, perform CPR. If bradycardia continues, move on to the following treatment:

Epinephrine administration
Atropine for increased vagal tone or primary AV block
Consider transthoracic pacing and transvenous pacing
Treat the underlying cause
If a pulseless arrest occurs, use the Pediatric Cardiac Arrest Algorithm

In all situations, if bradycardia does not continue to be obvious, it should still be monitored over time, and a specialist consultation should be considered.

PALS Cardiac Arrest Algorithm

The PALS cardiac arrest algorithm is one of the most important tools to utilize as a rescuer. Though it is more complex than other algorithms because numerous potential outcomes can occur, using a PALS algorithm cheat sheet for cardiac arrest allows you to easily see each of the steps to take to navigate the process.

Though reading this may be more confusing than using the cheat sheet, here is how an algorithm chart like this can help you if you are faced with a situation where a child exhibits a lack of proper heart rate.

Activate emergency response first.

Start CPR by providing oxygen and attaching a monitor and defibrillator to the patient.

Next, determine if there is a shockable rhythm present. Let’s say NO shockable rhythm was detected. Follow this algorithm:

PEA/Asystole
Provide CPR for two minutes.
Provide IV/IO access
Provide epinephrine every three to five minutes without stopping CPR
Consider advanced airway needs.

At this point, if there is still no shockable rhythm, you will continue CPR for an additional two minutes and try to treat any reversible causes. If no shockable rhythm results:

Administer a shock.
Provide CPR for two minutes
Provide epinephrine every 3 to 5 minutes
Consider advanced airway and capnography

If no shockable rhythm exists after this, administer another shock. Then provide:

CPR for two minutes
Amiodarone for lidocaine
Treat reversible causes

Now, let’s take a step back to the beginning. You activated emergency response, started CPR, provided oxygen, and attached a monitor and defibrillator. In this example, a shockable rhythm is determined. You would follow the next steps:

VF / PVT
Administer a shock
Provide CPR for two minutes
IV/IO access without interruption in CPR

Then, determine if there is a shockable rhythm. If not, follow the same steps as above:

Administer shock
Provide CPR for two minutes, epinephrine every 3 to 5 minutes, and consider advanced airway and capnography
If there is still no shockable rhythm, provide amiodarone or lidocaine and treat reversible causes

As you can see from the PALS cardiac arrest algorithm, having a flow chart that outlines each step is critical.

CPR Quality Matters

Keep in mind that providing quality CPR is critical in a critically ill child. Yet, a study reported by a group of researchers from the Children’s National Health System found that improving the quality of CPR provided throughout any of these algorithms and treatment processes can significantly improve a patient’s ability to see improvement.

The algorithm provides you with specific steps to take to provide care, but you must meet the quality CPR requirements as well.

For the PALS algorithm related to cardiac arrest, consider the following elements of CPR quality:

Rate of 100 to 120 compressions each minute
Compression depth for children should be one-third diameter of the chest. That is about 1.5 inches in an infant and 2 inches in children.
Minimize any interruptions to the process.
Do not over-ventilate the patient.
Rotate the compressor every two minutes.
In situations where there is no advanced airway, one provider uses a 30:2 compression ventilation ratio, and two providers use a 15:2 compression ventilation ratio.
If there is an advanced airway, 10 to 15 breaths per minute for one provider and 20 to 30 breaths per minute for two providers with continuous chest compressions.

The PALS algorithm also provides instructions on providing care in these situations. Take a look at the following details (besides the expected CPR quality) that should be provided.

Shock Energy

According to the PALS algorithm, use the following shock energy for a child:

First shock: 2 J/kg
Second shock: 4 J/kg
Subsequent shocks: ≥ 4 J/kg
Maximum dose of the shock: 10 J/kg or adult dose

Return of Spontaneous Circulation

This indicates that the pulse and blood pressure have returned. In this situation, spontaneous arterial pressure waves with intra-arterial monitoring is necessary.

Advanced Airway

This includes a supraglottic advanced airway or the use of an ET intubation. Waveform capnography will confirm and then monitor the ET tube placement. Once the airway is established, provide one breath every 2 to 3 seconds, up to 20 to 30 breaths per minute.

Drug Therapy

Another core component of this treatment process relates to drug therapy. The following are the recommendations for PALS algorithm steps for cardiac arrest:

Epinephrine IV/IO dose: 0.01 mg/kg (Repeat every 3 to 5 minutes; if there is no IO/IV access, may give an endotracheal dose of 0.1 mg/kg.)
Amiodarone IV/IO dose: 5 mg/kg bolus during cardiac arrest (May repeat up to two times for refractory VF/pulseless VT.)

It is critical to know what to do in these situations for many reasons. For example, the Emergency Medicine Clinic’s research shows that in nearly all situations, cardiac arrest occurs as a secondary event that progresses from a primary respiratory event. Knowing this, you know to focus first on improving the patient’s breathing and follow the step-by-step process listed above.

The Benefits of Having a PALS Certification

It is quite important to point out that while these PALS algorithms are a critical lifeline for providers as they meet the needs of patients in real time, they do not provide the details that you need to confidently manage the entire process. In other words, you need the PALS certification as well. There are several key benefits to completing this court. Consider some of the most important benefits of the PALS Certification.

PALS Certification is extensive. This type of certification provides education and training for child and infant CPR, changes to pediatric advanced life support, and provides a detailed, systemic approach to pediatric assessment. You learn a great deal, which helps you save the life of a patient.
Certification is necessary for professional development. For many people in the medical field, having a PALS certification may be a requirement or a recommendation by their employer. Obtaining this certification enables you to provide quality care for critically ill patients.
For a bystander or family member, it is a lifeline. If your child is chronically ill, has disabilities, or is in some other way at high risk for an emergency situation, it is critical to know how to take action to protect the child’s life. This certification enables that.

Consider the value of taking a PALS certification even if you do not fit any of the above profiles. A study by the Children’s Hospital of Philadelphia found that the number of pediatric out-of-hospital cardiac arrest events is low but high enough that having the ability to treat the patient can be essential. In other words, bystander education on how to care for a patient can improve the patient’s ability to survive.

Being able to provide critically ill patients with the specific care they need in a timely and efficient manner can save a life. Get your certifications to do this from Advanced Medical Certification. Our 100% online courses adhere to the ILCOR Standards and Guidelines, meaning you can be assured of the quality of your education and training in such a critical situation. Learn more about our BLS online certification now, or get your PALS certification renewed in no time.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

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What Does Basic Life Support (BLS) Stand For?

ACLS vs. ALS

ACLS vs. CPR

Synchronized Cardioversion: Guide to Safely Treating Rapid Arrhythmias

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Sep 10, 2024, at 6:43 pm

Picture it: Your patient is in front of you, their heart racing uncontrollably—and yours is rising too. That beat is somewhat erratic but relatively predictable. You’ve tried medication, but nothing is working. The clock is ticking. You need to act fast. In this moment, synchronized cardioversion with its precise shock to the heart could completely turn this situation around.

As a health care professional, you often face high-stakes, life-threatening emergencies like this. Synchronized cardioversion is one tool you learn to use to save lives when time is a luxury you don’t have. Understanding this technique isn’t just about knowing how it works. It’s about knowing when to use it and how to do it safely.

We offer Online ACLS Certification and Renewal

In this go-to guide, I break down everything you need to know and share some ways you can test your knowledge and decision-making before you have a patient on the table. We’ll compare it to other techniques like defibrillation and discuss how to manage the risks.

Whether you’re studying for your ACLS certification exam or you want to casually learn more about this topic, this guide will give you more confidence in those critical moments.
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What is Synchronized Cardioversion?

Think of the heart like an orchestra. When it’s healthy, every beat follows a steady rhythm. That pace does increase and decrease based on what the patient is doing or, in some cases, thinking. However, there’s a method to it. It’s music!

Now, sometimes, this rhythm gets out of sync. It’s up to the conductor to get everything working together again. They have to get everyone’s attention with a bold move that forces the musicians back in line with the piece they rehearsed.

This is synchronized cardioversion, a controlled electrical shock that stops arrhythmia (irregular heartbeat). This jolt halts the chaos that has ensued, giving the heart an opportunity to reset itself.

How Does Synchronized Cardioversion Work?

Here’s the science behind it: the machine, usually a defibrillator, monitors the heart rhythm to time the shock. These machines can detect the R wave (the point of contraction) and deliver the shock at that moment. This timing is critical because if the shock were not so precise, it might deliver the shock on T wave (repolarization).

The T wave represents the repolarization of the ventricles (when ions flow back in). Then, during depolarization, ions (electrolytes) flow out of the cells, initiating a contraction. Shocking on a T wave is like trying to breathe out when you’ve already emptied your lungs. You can’t breathe out anymore because you have to breathe in first. The shock prevented the ions from coming back into the cells. They must repolarize so that they can depolarize.

When is Synchronized Cardioversion Used?

Use this method when your patient has a rapid heartbeat that is somewhat organized. Organized arrhythmias include:

Atrial fibrillation (AFib)
Atrial flutter
Ventricular tachycardia (VTach)
Supraventricular Tachycardia (SVT)

This technique is also part of the protocols you’ll learn in ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support) courses. This 100% online training from Advanced Medical Certification teaches you the precise moments when synchronized cardioversion is the best treatment. Whether you’re managing an emergency in the ER or treating a patient in an ambulance, knowing when to act—and how—can make all the difference.

Let’s take a closer look at these indications for synchronized cardioversion. Here are the core rhythms treated with this procedure.

Atrial Fibrillation (AFib)

AFib is one of the most common arrhythmias treated with synchronized cardioversion. In AFib, the upper chambers of the heart (the atria) beat irregularly and rapidly, causing poor blood flow. The left atrium doesn’t fill completely before sending blood to the left ventricle on its way to the lungs. At the same time, the oxygenated blood returning to the heart doesn’t fill the right atrium before being sent to the right ventricle. The heart is working harder than it should have, and as it tries to keep up with the demand, heartbeats become irregular.

If your patient has AFib and medications aren’t working, synchronized cardioversion can help restore a regular heart rhythm. This is crucial to prevent complications like stroke or heart failure.

Ventricular Tachycardia (VTach)

VTach is another arrhythmia that requires urgent treatment. VTach occurs when the lower chambers of the heart (the ventricles) beat too quickly, leading to inefficient pumping of blood to the lungs and then out to the body. Most often, VTach calls for a timed shock. However, I’ll share an exception in the next section, so read on!

These exceptions are why it’s essential to study life-saving algorithms. They guide you through critical decision-making so you can feel confident in making a split-second judgment on what to do next.

Atrial Flutter

Similar to AFib, atrial flutter is a rapid, organized arrhythmia that affects the atria. The heart may beat fast but in a regular pattern. If your patient is symptomatic or unstable, synchronized cardioversion can correct the rhythm and prevent further complications.

Supraventricular Tachycardia (SVT)

This refers to rapid heartbeats originating above the ventricles, often in the atria. SVT can cause symptoms like palpitations, dizziness, or chest pain. If medications don’t work, synchronized cardioversion can restore a normal heart rhythm.

Synchronized cardioversion is used when the patient is stable but showing symptoms. Your quick action is vital to prevent VTach from progressing to ventricular fibrillation.

In ventriclar fibrillation (VFib) the ventricles become so uncoordinated that very little blood makes it out to the body. This is a life-threatening emergency. According to Mayo Clinic, VFib is one of the most common causes of sudden cardiac death.

To apply this information effectively, you must know how to identify rhythms. You’ll find this free ACLS training helpful if you need a refresher.

Synchronized Cardioversion vs Defibrillation

Both procedures deliver shock to the heart. However, they serve different purposes.

You’ll use synchronized cardioversion to treat organized arrhythmias (outlined above) with a timed shock. Deliver the shock at the safest moment, which is the R Wave (depolarization phase) on the ECG, to avoid triggering a dangerous arrhythmia like VFib.

On the other hand, you’ll use what I’ll call regular defibrillation when the heartbeat is already disorganized or your patient has pulseless VTach, that exception I mentioned earlier. To give this patient the best chance of survival, you are prioritizing delivering shock immediately over trying to time it because the brain isn’t getting any oxygen.

In defibrillation, the only timing decision involved is determining if your patient has a shockable rhythm, pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF)

Synchronized Cardioversion vs. Unsynchronized Cardioversion

Unsynchronized cardioversion is simply another name for defibrillation without precise timing. When you take an ACLS course, these terms may be used interchangeably in the study materials or the test.

Synchronized Cardioversion Joules in ACLS (for Adults)

In ACLS protocols for adult tachycardia, the recommended energy levels for synchronized cardioversion vary based on the arrhythmia. You’ll typically begin with the lowest indicated joules before increasing for subsequent shocks.

Here’s a quick guide for patients with tachycardia and a rhythm that calls for this procedure.

Narrow Regular: 50 to 100J

A narrow QRS complex describes electrical activity that is primarily occurring in the atria or above the ventricles while the heartbeat is fairly predictable.

This might be the case with Supraventricular Tachycardia (SVT).

Narrow Irregular: Biphasic 120J to 200J / Monophasic 200 J

This also describes electrical activity in the atria or above but with an irregular rhythm.

Wide Regular: 100J

A Wide QRS complex indicates electrical activity coming from the ventricles, and the rhythm is fairly regular.

Wide irregular: Defibrillation Dose (NOT Synchronized)

Wide QRS complex again refers to ventricular-origin electrical activity, but the beats are erratic to the point of unpredictability. Synchronized is not called for here.

Examples might include Ventricular Fibrillation (VFib) or pulseless VTach.

Synchronized Cardioversion Joules in PALS (for Children)

When administering a shock to a child, it’s important to follow your PALS training. If you have the potential to work with children in an emergency setting, you should definitely get PALS certified. You can do it 100% online in a convenient self-paced course and earn continuing medical education credits to put toward your license renewal.

For children, you need to know (or make an educated guess) about the child’s weight. Administer .5 -1 joules per kg. If it fails to correct the heart rhythm, increase to 2 joules per kg. For those who don’t think in metrics, 1kg is 2.2lb.

So, a 60lb child (perhaps an 8-10 year old) weighs 27kg (rounded). 27kg x .5J to 1J = 13.5J – 27J

How Do I Use AED for Synchronized Cardioversion

Some advanced AEDs (automated external defibrillators) have a synchronized cardioversion mode. If you’re in an out-of-hospital setting where an AED is available, you’ll need to confirm that the device has this feature. Follow the prompts from the AED, and ensure it’s set to “sync” mode before delivering the shock.

Your ACLS certification will increase your confidence in manual defibrillators and AEDs, ensuring you’re ready to act in any situation with any tool you might have.

Step-by-Step Cardioversion Procedure

1. Monitor and Assess

Connect your patient to the cardiac monitor to observe their ECG and identify the type of arrythmia. Determine if your patient’s rhythm is suitable for this procedure.

2. Prepare the Defibrillator

Set up your defibrillator (which could be an AED) to synchronized mode. Then, select the appropriate energy level.

At this time, consider vagal maneuvers before proceeding. In patients with Supraventricular tachycardia (SVT), these non-invasive techniques activate the parasympathetic nervous system, telling the heart to slow down. This is safer and can slow the heart down, allowing it to re-establish a normal rhythm on its own. (NIH.gov)

3. Consider Sedation for Synchronized Cardioversion

This is a painful and potentially anxiety-inducing procedure, and the patient is probably awake and aware if they have an appropriate rhythm. Use a drug like midazolam (a sedative) or propofol (an anesthetic) to quickly sedate them or dull the pain. (NIH.gov). The drugs used vary by country, clinic, and situation, so you should review your facilities’ guidance here.

4. Position the Pads

Place the pads on the patient’s chest according to the manufacturer’s instructions ((anterior-posterior or anterior-lateral positions).

5. Charge the Defibrillator

Charge the defibrillator to the selected energy level based on the type of arrhythmia. Again, review ACLS algorithms for more details.

6. Clear the Area

Ensure no one is touching the patient or the bed. Loudly announce “Clear” before delivering the shock to your patient in the next step.

7. Shock

Press the “shock” button, and the defibrillator will synchronize with the R wave and deliver the shock to your patient at the safest moment.

8. Monitor and Reassess

Immediately check your patient’s rhythm to determine if you need to shock again. If the arrhythmia persists, increase the energy level and repeat the procedure. If the rhythm normalizes, monitor the patient.

Post-sedation care is critical here. The patient must be closely monitored until they are fully awake and stable.

Risks and Side Effects of Synchronized Cardioversion

Knowing the risks can help you anticipate how your patient may react to the procedure. This allows you to prepare for several potential outcomes.

Skin Burns: The electrical shock may burn your patient’s skin. Proper placement of pads and gel can reduce this risk. However, you should evaluate the patient’s skin to treat burns after, as necessary.
Worsening Arrhythmias: In some cases, your patient’s arrhythmia may worsen into ventricular fibrillation (VF). Shocking on the T wave should prevent this, but it can happen.
Stroke Risk: If your patient has Afib, they may experience a blood clot, which could lead to a stroke. When time allows, your Afib patient should receive anticoagulants for several weeks before the procedure to prevent this.
Hypotension (Low Blood Pressure): Your patient’s blood pressure could drop into bradycardia after the procedure, making post-intervention monitoring critical.
Cardiac Arrest: This one is rare because of the precise timing of the shock. However, the heart could stop. If it does, you’ll need to follow what you learned in ACLS training or PALS if your patient is a child.

If the patient is/was sedated, they may also experience confusion, nausea, and trouble waking up.

Be Ready for Demanding Medical Situations with Advanced Training

Advanced medical training from Advanced Medical Certification prepares you for emergency situations like these. Algorithms that follow ILCOR’s evidence-based protocols guide you through the decision-making process while reminding you of the proper steps, considerations, and doses. Online PALS and ACLS Megacodes help you apply what you learned before facing a real-life emergency.

To earn continuing medical education credits and update your skills with the latest evidence-based procedures, get the PALS/ACLS bundle to save money while you save lives.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

Keep reading

What Does Basic Life Support (BLS) Stand For?

ACLS vs. ALS

ACLS vs. CPR

Adenosine Dose Guidelines and Indications

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Sep 3, 2024, at 5:46 pm

Adenosine, a prescription-strength medication sold under the names Adenocard and Adenoscan, is an antidysrhythmic medication given to help stabilize the heart rate when there is an indication of paroxysmal supraventricular tachycardia (PSVT). This condition is often associated with accessory bypass tracts, such as those found in those with Wold-Parkinson-White Syndrome.

Though various indications occur, an adenosine dose can be highly effective, quickly improving patients’ heart rates.

What Is Adenosine?

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Adenosine is a medication administered to restore normal heart rhythm, also called sinus rhythm. A medical professional injects this medication directly into the patient’s vein during a medical emergency, clinic setting, or hospital.

It may be prescribed to adults, children, and, in some cases, infants, even newborns, to restore heart rhythm to sinus rhythm. Numerous precautions are necessary when providing this medication to a child.

When and How Adenosine Is Used

As noted by StatPearls through the National Library of Medicine, an adenosine dose works as both a diagnostic and therapeutic agent. Once injected into the vein of the patient, the drug works through the purinergic adenosine receptors located throughout the body.

For Diagnostic Agents

For diagnostic use, adenosine is used in the myocardial perfusion stress imaging process. It can provide vasodilatory effects, providing indication of abnormal flow or movement of blood through the heart.

For Therapeutic Agents

Adenosine may also be used as a treatment. In this way, it works as an antiarrhythmic medication for supraventricular tachycardia (SVT). It may be used to quickly restore the function of the heart into sinus rhythm in these situations.

Dosing of Adenosine

The proper administration of an adenosine dose depends on the situation. However, the following is a common treatment process:

The first dose of adenosine is typically 6mg and administered rapidly within 1 to 3 seconds.
A 20 ml NS bolus is delivered.
If the SVT does not convert within 2 minutes, a second 12 mg adenosine dose is given using the same method.
A 20 ml NS bolus is given after.

In nearly all situations, adenosine dose administration should happen quickly to revert the heart rhythm.

Patients Taking Dipyridamole or Carbamazepine

For patients taking either dipyridamole or carbamazepine, the initial adenosine dose drops to just 3 mg. It should be given slightly slower. These two medications can impact the effectiveness of adenosine, requiring less of the dosing to achieve similar results.

Heart Transplant Patients and Central Line Use

In patients who have had a heart transplant, as well as those with a central line in use, prolonged asystole is possible with the normal adenosine dose. For this reason, it is common to provide a lower adenosine dose of 3 mg in these patients.

Indications for Use of Adenosine

As documented in the JACC Journals, adenosine is a ubiquitous extracellular signaling molecule that provides specific functionality to human physiology due to the presence of adenosine receptors throughout the body. These receptors are present in different organ systems, though they are primarily focused on coronary circulation.

Indications for use are numerous:

It can be used in patients after vagal maneuvers are completed, providing a first-line therapy for diagnosing and then treating SVTs. It may also be used as a second-line treatment that includes beta and calcium channel blockers.

Additionally, research indicates it may be helpful in reducing the risks associated with glaucoma, one of the most common causes of blindness. In this way, an adenosine A 1 receptor agonist called trabodenoson increases aqueous humor outflow by stimulating the trabecular meshwork cells’ production of matrix metalloproteinases.

Also notable, Adenosine may also be used in pediatric patients who exhibit SVT, which is rather common in very young children. If not treated immediately and effectively, it can transition to cardiogenic shock and heart failure.

The Use of Adenosine in Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Depending on the type of care provided and the standards followed, adenosines may be administered as a class 1 recommendation for hemodynamically stable STV.

In pediatric patients with SVT, the condition is often dependent on the atrioventricular node’s function to be sustained. The arrhythmia is stopped with the use of adenosine, which primarily affects the atrioventricular node. There are two primary reasons why adenosine failure occurs in STV. The first is the medication’s short half-life. The second is for non-atrioventricular node-dependent SVT.

What Is Adenosine Function in the Body?

Adenosine is, as noted by the National Library of Medicine, a purine nucleoside base with the molecule adenosine triphosphate, or ATP. It works through the receptors in the body called purinergic adenosine receptors, which impact the nervous system, immune system, respiratory system, circulatory system, and urinary systems in the body. Specifically, these receptors are in the cardiac atrioventricular nodal tissues (AV node).

It may also act on the receptors in the cardiac AV node to slow conduction times, as a result of the activation of specific potassium channels, which forces potassium out of the cells and limits calcium influx. As a result of this, it slows the nodal cardiac myocyte.

Using Adenosine In Emergency Situations

The first step in most cardiac emergencies where STV is present is to use vagal maneuvers. If this process fails to terminate stable narrow-complex SVT, adenosine is used.

In patients who are unstable but have a regular but narrow QRS complex, this medication may be used prior to cardioversion application in an effort to improve outcomes.

When given through a rapid IV bolus into the vein, the medication slows cardiac conduction related to the AV node specifically. The rapid bolus will interrupt reentry pathways, which are what causes SVT, through the AV node. This aids in returning the patient to sinus rhythm.

In emergent situations, the adenosine dose must be administered quickly. This is because the medication is rapidly absorbed by the body’s red blood cells as well as blood vessels and endothelial cells. It is then metabolized naturally through the body. Without rapid dosing, a significant impact to create changes in the heart’s rhythm prior to the medication being metabolized is often challenging.

First Dose of Adenosine for SVT

The first dose of adenosine for SVT should be a 6 mg administration over 1 to 3 seconds directly into a patient’s vein. Follow this by a 20 ml NS bolus.

Second Dose of Adenosine for SVT

Prior to considering the second dose of adenosine, practitioners should wait 1 to 2 minutes to determine if the heart reverts to normal rhythm. If it does not, a second dose may be administered. What is the second dose of adenosine? In most patients, it will be 12 mg given in the same 1 to 3 second push. It should be administered quickly.

Adenosine Side Effects

It is critical to consider the potential side effects of the use of adenosine in some patients. Some of the most common adenosine dose side effects include:

Flushing of the face
Brief asystole
Brief bradycardia
Chest pain
Chest tightness

Notably, this medication should not be used for some arrhythmias. It should not be used for:

Polymorphic wide-complex tachycardia
Irregular tachycardia
Unstable VT

When used in patients with these conditions, deterioration of health is likely to occur.

Contraindications of Adenosine

Additionally, intravenous adenosine should not be used in those with a second or third-degree A-V block unless the patient has a functioning artificial pacemaker. It should not be given to patients with sinus node disease, including sick sinus syndrome or symptomatic bradycardia (unless that patient has an artificial pacemaker that is functional).

Clinical Study of Adenosine Dose

An FDA release of information provided an update on the dosing of adenosine in most patients. In controlled studies in the US, the dosing of adenosine was observed at several levels: 3, 5, 9, and 12 mg.

The study found that 60% of patients with paroxysmal supraventricular tachycardia converted to normal sinus rhythm within one minute of the EV dosing of 6 mg. A smaller percentage of those given 3mg converted, and when they did not, 6 mg was administered. Additionally, 92% of patients were converted after a bolus dose of 12 mg was given.

The study also looked at patients given a placebo bolus injection. Of those, 7 to 16% of patients converted after being given 1 to 4 placebo injections.

The FDA notes in its research that:

Adenosine is not effective in converting PSVT, including atrial flutter
Atrial fibrillation
Ventricular tachycardia

The study found similar recants across all patients in various demographics and conditions. That includes those who were using digoxin prior and those not doing so. It included those with Wolff Parkinson White Syndrome and those without.

Potential Warnings When Administrating Adenosine Dose

There are some key warnings that must be considered in providing adenosine dose instructions, as noted by the FDA:

Heart block patients: when used, adenosine may create first-, second-, or third-degree heart block because it decreases conduction in the AV node. If a patient experiences a high-level block when given an initial dose, they should not be given a second dose.
Arrhythmias at cardioversion: Patients may develop new rhythms at the time of cardioversion. These may initially appear on the electrocardiogram but last just a few seconds and do not require intervention. These may include premature ventricular contractions, atrial fibrillation, atrial premature contractions, since tachycardia, skipped beats, sinus bradycardia, and others.
Bronchoconstriction: Adenosine also works as a stimulant for the respiratory system. When given through an IV, it can increase minute ventilation and reduce arterial PCO0, which can cause respiratory alkalosis. Also note that when given through inhalation, it may cause bronchoconstriction in some patients who are asthmatic.

Adenosine and Advanced Cardiac Life Support

Advanced cardiac life support (ACLS) is a life-saving set of skills designed specifically to treat cardiac emergencies. Those who do not have ACLS training may wish to obtain it to better understand how adenosine dose is applied to various types of patients in various states of cardiac health and function.

Follow these steps associated with the ACLS algorithms in patients with symptoms:

Determine the cause of the tachycardia occurring, if possible, but do not delay treatment to do so.
Utilize vagal maneuvers for immediate support.
Apply synchronized cardioversion with a defibrillator if there is no improvement
Treat with medications
Maintain that patient’s oxygen saturation at 94% or higher.

If the patient is stable at this point, move to the ER facility for treatment. If the patient is unstable due to hypotension, decreased LOC, chest pain, or shock, move forward with care.

Complete synchronized cardioversion

If the patient is stable, follow these steps:

Establish an IV for the patient
Consider the use of adenosine 6 mg bolus. If, after 2 minutes, the SVT remains, consider a second dose at 12 mg.
If adenosine is not effective, treatment with procainamide or amiodarone
If continued complications, consider antiarrhythmic infusion

The ACLS tachycardia process listed here is followed when patients have tachycardia, which is a fast heart rate of 150 beats per minute or more, and they have a palpable pulse. In patients where there is no palpable pulse for 10 seconds, rescuers should move to ACLS cardiac arrest treatment for Vtach or Vfib.

Follow the immediate response methods expected if a patient presents with tachycardia with a pulse. That includes:

Maintain an open airway
Provide breathing assistance to the patient if necessary
Apply monitors to determine blood pressure, blood oxygenation, and cardiac rhythm
Supplement with oxygen to maintain 02 saturation of 94% or higher.

Adenosine Dose Insights: Using Adenosine for SVT Effectively

Recognizing the importance of adenosine dose administration could save a life. It is critical for rescuers to view the use of adenosine as an emergent treatment for SVTs, and to apply the necessary ACLS algorithm to treat patients immediately with the proper dosing. In most situations of adult treatment, this begins with a first dose of 6mg followed by a second does of 12 mg if the patient does not respond within 2 minutes. For infants, the initial dose is 3mg.

For a first responder who needs to know how to CT quickly, complete your ACLS online certification to be sure you are ready to care for your patients. Your ACLS training program will provide hands-on experience in learning how to assess a situation and provide effective treatment to patients in life-threatening situations.

Turn to Advanced Medical Certification to obtain the necessary training to help support your patients who may be facing SVTs that require a life-saving adenosine dose to save their lives by returning their heart to sinus rhythm.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

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What Does Basic Life Support (BLS) Stand For?

ACLS vs. ALS

ACLS vs. CPR

Respiratory Arrest: Essential Steps to Take When It Occurs

by Greta Kviklyte

Life Saver, AMC

Co-authored by Kim Murray, RN, M.S.

posted on Aug 28, 2024, at 3:15 pm

It is possible for a patient to exhibit with a strong heartbeat but without any signs of breathing. When this occurs, the individual could be suffering from respiratory arrest, a condition that is life-threatening and requires immediate medical attention. It is similar to cardiac arrest, but managed in a slight different manner to restore function to the patient.

Respiratory Arrest Definition: What Is Respiratory Arrest?

Respiratory arrest occurs when a person stops breathing with or without any signs of cardiac function. One condition will lead to the other, warranting immediate medical care as noted by the National Library of Medicine.

We offer Online CPR and BLS Certification

Data from the Merck Manual indicates that any interruption of pulmonary gas exchange for over five minutes has a high chance of creating irreversible damage to a patient including to vital organs like the brain. If respiratory arrest does not improve quickly, cardiac arrest almost always occurs next.

It is possible to provide ventilation to restore breathing. However, if done too aggressively, this can create a negative hemodynamic consequence especially during the peri arrest period if cardiac output is low.

The objective in treating respiratory arrest is to restore adequate ventilation of the patient and ensure oxygenation without compromising the cardiovascular system in any additional manner.

How Does Respiratory Arrest Occur?

Respiratory arrest may occur for various reasons. The most common instances are caused by:

Obstruction of the airway
Decreased respiratory effort
Respiratory muscle weakness

To further define these, consider the following common but not exclusive indications of respiratory arrest causes, as noted by the National Institutes of Health.

Airway Obstruction Indications

An upper airway obstruction occurs when there is something blocking the airway above the vocal cords. This includes nasopharyngeal and oral cavities, as well as the larynx. Some common causes include:

Vomit
Blood
Mucus
Edema of the vocal cords
Spasming of the vocal cords
Tumor
Trauma
Posterior position of the tongue
Pharngolaryngeal inflammation
Foreign body

In children who are under the age of three months, who are nose breathers, a blockage of the nasal pathway can also lead to respiratory arrest. This could indicate the need to pursue infant CPR.

Respiratory arrest can also occur as lower airway obstruction, occurring below the vocal cords. This includes the area of the trachea, bronchi, bronchioles, and alveoli. Some of the most common causes include:

Aspiration
Airspace-filling disorders, including pulmonary hemorrhage, pneumonia, and pulmonary edema
Drowning
Bronchospasm

Decreased Respiratory Effort Indications

A secondary common reason for respiratory arrest is a decreased effort in breathing. This may be brought on by concerns with the central nervous system, such as impairment. This may be due to a central nervous system disorder, metabolic disorder, adverse effects of medication or drug use, or mechanical defects.

CNS disorders typically include the onset of a stroke or tumor but may also be indicative of an infection. It may also be brought on by damage to the cervical spine, causing hypoventilation. Any instances in which there is an increase in intracranial pressure can also cause this to occur.

Numerous medications can slow the breathing rate and ability of a patient. This includes:

Sedative hypnotic drugs, including alcohol, benzodiazepines, and barbiturates
Opioids
Gapapentinoids, including pregabalin and gabapentin

These drugs reduce respiratory effort in the patient and can increase dead space ventilation, resulting in prolonged liberation from mechanical ventilation for those who have a diminished tidal volume in a critical care setting.

Some metabolic disorders can also cause respiratory arrest, including those who have restrictive ventilatory defects or obesity. Medical defects, including respiratory muscle dysfunction, can contribute to a reduction in breathing ability.

Respiratory Muscle Weakness Indications

Numerous factors can lead to the onset of weakened respiratory muscles, leading to the onset of an inability to breathe. This may be caused by respiratory muscle fatigue, neuromuscular diseases, as well as corticosteroid medications.

Respiratory muscle fatigue occurs in situations in which a person breathes for an extended period of time at a minute ventilation that exceeds about 70% of their maximum voluntary ventilation. This leads to metabolic acidosis or hypoxemia. This may be brought on from conditions such as COPD or dysfunction of the muscles.

Neuromuscular dysfunction can occur if there is damage to the spinal cord or the onset of conditions like botulism, myasthenia ravis, or Guillan-Barre syndrome occur. Also notable when a patient is on bedrest and is being given corticosteroids or neuromuscular blocking medications, this can lead to muscle weakness.

Respiratory Arrest vs Failure

Respiratory failure is a life-threatening condition that leads to an impairment of oxygenation, carbon dioxide elimination or both, as defined by the Merck Manual. Respiratory failure occurs when the repository does not oxygenate and eliminate carbon dioxide from the blood. It may be due to either inadequate oxygenation or a lack of elimination of carbon dioxide, both of which are critical components. There are many instances in which both occur.

The most common manifestations of respiratory failure include:

Dyspnea
Use of accessory muscles of respiration
Diaphoresis
Altered consciousness
Tachypnea
Tachycardia

In nearly all situations, it will lead to respiratory death. As a critical condition, it is essential that rescuers know exactly how to support a patient experiencing these types of failure.

Symptoms of Respiratory Arrest

It may not be immediately obvious that a person is not breathing, which is why rescuers must be observant of at-risk individuals for movement in the chest indicating breathing or a lack of it. Some of the most common symptoms may include:

Extreme shortness of breath, a feeling of not being able to pull in enough air, called dyspnea
Rapid breathing, called tachypnea
Fast heart rate, feeling heart palpitations
Extreme tiredness
Restlessness
Pale skin
Excessive sweating
Blurry vision
Bluish tint to the lips, skin, or nails
Agitation and confusion
Behavioral changes, such as not acting normal
Headaches

How to Manage Respiratory Arrest

As with any type of basic life saving process, rescuers must know how to react to the situation occurring. This typically means completing BLS appropriate for the situation including ACLS sequences as necessary.

Complete the following guidelines according to your BLS survey expectations:

Check for patient responsiveness
Activate EMS support
Check for circulation
Defibrillate

In respiratory arrest, the patient will still maintain circulation. This means that there is typically no need to defibrillate the patient. There is also no need to complete chest compressions or provide formal CPR methods for the patient. Instead, the treatment involves creating successful ventilation, or opening up the airway to allow for breathing.

To follow the ACLS survey, complete the following steps:

Airway
Breathing
Circulation
Differential diagnosis

In these situations, respiratory arrest typically requires establishing an open airway, a way for the patient to pull air into their body and expel carbon dioxide. Use the tools available to you within the given situation and act in an appropriate manner.

Here is an example. If a patient is experiencing respiratory arrest in a park, the first step will be to open the airway. The head title/chin lift method or the jaw thrust maneuver is the ideal situation. Use the jaw thrust method in situations where there could be damage to the cervical spine.

In situations where there is an oropharyngeal or nasopharyngeal airway device available, such as in a medical center setting, use that to establish an open airway for the patient.

Understanding the Administering of Artificial Respiration

In situations where the patient receives artificial respiration, the rescuer must be cognizant of the fact that they are breathing for the patient. As a result of this, it is critical that they do not excessively ventilation the patient. Rather, notice the chest rising and falling with each breath.

In situations where it is possible to do so, rescuers can supply supplemental oxygen to the patient. This includes using as high as 100% oxygen initially. However, this should be tritating downward. The ultimate goal is to achieve a blood oxygen level of at least 94% or higher. This is based on measurement through pulse oximetry.

Navigating Respiratory Arrest and Cardiac Arrest

It is critical for rescuers to realize that, at any moment, a person with respiratory arrest could enter into cardiac arrest as well. This can happen quickly or over a period of a few minutes. As a result, rescuers need to check the patient’s pulse on a consistent basis to determine if circulation is continuous.

In situations where the patient’s heart stops, follow the necessary treatment and treatment for cardiac resuscitation.

Treatment of Respiratory Arrest Methods

Depending on the environment and the level of care available, the specific treatments for respiratory failure typically include:

Application of mechanical ventilation: This is the process of using a breathing machine and a tube placed into the airway to open up the airway and move air in and out of the lungs.
Extracorporeal membrane oxygenation (ECMO): Used in a medical treatment center, such as an emergency room, placing a patient on ECMO is necessary to support oxigentation needs. This machine works to oxygenate the blood and remove carbon dioxide.
Oxygen therapy: In some situations, a patient may be given extra oxygen supplied through a breathing mask or cannula. This can be done in an emergency situation and it may remain over time.
Fluids: Patients are also given fluids through an IV. The fluid helps to increase blood flow through the body, and may help to bring oxygen-rich blood to the tissues, minimizing damage to organs.

In addition to these strategies for the treatment of respiratory arrest, treatment will need to focus on the underlying cause. For some patients, this may require surgical interventions to remove blockages in the airway. For others, it may be necessary to consider cardiac function, edema, and lung conditions. In an emergent situation, a rescuer does not need to apply these longer-term treatments but should be cognizant of the risks the patient faces, such as spinal cord injury if moved.

The ultimate goal of treatment is to restore the function of the body to breathe. To do this, rescuers and emergency care workers must work through the following steps until respiratory arrest improves or additional treatment options are obtained:

Establish an airway and control it to maintain it
Utilize an airway or respiratory device to maintain the function of breathing
Tracheal intubation
Surgical airway creation
Medications to aid in intubation

Patients require care right away. Any exposure to a lack of breathing for more than a few minutes begins to lead to brain damage, making resuscitation difficult for the patient.

High Risk Patients for Respiratory Arrest

A person eating can be a victim of respiratory arrest. However, there are some scenarios in which a person is at a much higher risk of developing respiratory arrest than others. The following are risk factors for this condition:

Individuals with lung conditions, including acute respiratory distress syndrome, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, cystic fibrosis, asthma, Pneumonia, Pulmonary edema, and pulmonary embolism
Patients exhibiting signs of chest, spinal cord, or brain injuries such as strokes
Heart and circulatory conditions and diseases, including previous heart attack sufferers, those with congenital heart disease, shock, and heart failure
Patients with muscular dystrophy, ALS, severe scoliosis, or Guillain-Barre Syndrome
Patients with a history of exposure to lung irritants, including from smoking or exposure to air pollution, dust, or chemical fumes
Drug use and excessive alcohol consumption
Surgical conditions that require sedation

How to Gain Education, Training, and Certification for Respiratory Arrest

Those who wish to be trained to be ready to act in the event of respiratory arrest can pursue one or more certification options. This includes earning CPR, AED, and First Aid Certifications to help the patient to restore breathing and heart function. This specific treatment will provide insight into infant CPR and chocking, child CPR and choking, as well as application of AED and CPR treatments in an emergency situation.

Additionally, BLS Certification can also provide training and education to those who wish to provide this life-saving treatment to patients in need. For those who are becoming a nurse, doctor, or other provider of medical care, obtaining your BLS certification could be critical to meeting the needs of patients in life-threatening situations.

Complete a BLS Online Certification

Advanced Medical Certification provides an opportunity for anyone to learn how to provide basic life-saving support to a person experiencing respiratory arrest. Learn more about the available BLS online certification course that can provide you with the necessary education and training to know how to react when this type of emergency event occurs.

Explore the other options offered by Advanced Medical Certification to improve your ability to help support people facing emergency needs. Learn more about the services and certifications available at Advanced Medical Certification now.

About Greta

Reach out to Greta at greta.kviklyte@advmedcert.com.

Keep reading