Advanced Medical Certification

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ACLS Essentials

  • In any arrest situation, immediate recognition and intervention with proper CPR are crucial.
  • When approaching the scene and the patient, mentally prepare yourself for resuscitation.
  • Do not injure yourself—ensure the safety of the scene.
  • Focus on early CPR and quick defibrillation in BLS.
  • Oropharyngeal airways shouldn’t be used with conscious patients.
  • Pull the jaw into the mask rather than the other way around (the mask onto the face), as the latter can possibly close the airway.
  • IV or IO is the preferred routes for drug delivery; ET route is discouraged and unpredictable.
  • Amiodarone doses vary for VF and VT with a pulse.
  • After delivering a shock, resume chest compressions right away; minimize interruptions.
  • Targeted temperature management is utilized after return of spontaneous circulation.
  • Familiarize yourself with specific cardiac rhythms, such as asystole, Torsades de Pointes, VT, VF, atrial fibrillation/flutter, SVT, and sinus tachycardia.
  • Asystole must be confirmed twice, in two separate leads.
  • Deliver a shock to treat both VF and pulseless VT.
  • Remember the reversible causes of cardiac arrest: the H’s and the T’s.
  • Capnography is a valuable tool in resuscitation. If PETCO2 is lower than 10 mmHg, attempt to improve CPR quality and investigate the advanced airway placement.
  • If capnography is still less than 10 mmHg, consider termination of efforts.
  • Patients with inferior myocardial infarction must be administered with nitroglycerin with caution, but avoid this if systolic blood pressure (SBP) is less than 90mmHg, or if within the last 24 hours, erectile dysfunction medication has been taken.
  • Confusion may be a presenting sign of a stroke.
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