Advanced Medical Certification

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Maintaining an open airway is crucial. It is the provider’s decision as to whether the patient will benefit more from an advanced airway at the risk of interrupting CPR. If the individual is capable of raising his or her chest without the use of the advanced airway, then do not pause CPR. But you can think about pausing CPR if there are other trained professionals nearby who are able to insert the airway.


One hundred percent oxygen should be delivered in cases of cardiac arrest. Blood O2 saturation must be greater than or equal to 94%, and a pulse oximeter must be used to measure this. Quantitative waveform capnography should be used whenever possible. The partial pressure of CO2 at a normal state is 35 to 40 mmHg. A ETCO2 of 10 to 20mmHg must be produced by high-quality CPR. You can consider pausing attempts at resuscitation only if the ETCO2 reading after 20 minutes is less than 10mmHG for an intubated patient.


Intraosseous access (IO) is allowed; however, whenever possible, focus on intravenous (IV) access. If available, use an intra-arterial line or a blood pressure cuff to monitor blood pressure. A cardiac monitor equipped with pads can be used to keep track of the heart rhythm. Follow the directions when making use of an AED, and whenever appropriate, give fluids. When indicated, cardiovascular medications must be administered.

Differential Diagnosis

In diagnosing, it’s always better to assess the likeliest causes before addressing the least likely causes. Stop CPR only to confirm a particular diagnosis; otherwise, it is critical to keep interruptions at a minimum.

Figure 9

Advanced Cardiac Life Support (ACLS) Certification Course

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