Advance Cardiac Life Support

Basic Principle: To sustain life, blood must circulate and blood must be oxygenated optimally. General guidelines: Take command. Obtain brief history. Identify and treat irreversible. 6Hs: Hypovolemia, Hypoxia, Hydrogen Ion (acidosis), Hyperkalemia or Hypokalemia (other metabolic problems), Hypothermia, Hypoglycaemia 6Ts: Tablets (drug overdose, accidents), Tamponade cardiac, Tension pneumothorax, Thrombosis coronary (MI), Thrombosis pulmonary (embolism), Trauma Step 1: Circulation Auscultate the precordial area for a heartbeat while palpating the carotid pulse. If negative, start CPR push fast, push hard. One cycle of CPR means 30 chest compressions, then 2 breaths given. Aim to accomplish 5 cycles for every 2 minutes. Note: place bedboard. Do effective 4-5 cms sternal compressions. Step 2: Oxygenate Optimally. Is the patient cyanotic? Is the patient still breathing? If negative, check airway and do ambu bagging with tight face mask. Note: Give 100% oxygen. Make sure ambu bag tube is connected to the oxygen tank. Suction secretions as needed. Hyperventilate initially. Step 3: Treat the cardiac rhythm. Assess cardiac monitor. Done simultaneously. 1. Insert IV line. 2. Intubate patient if necessary (for asystole, electromechanical dissociation, bradyarrhythmia, or persistent unstable rhythms). 3. Get ABGs if with pulse (treat hypoxemia and acidosis).