Pass ACLS Tip of the Day

Paul Taylor

Like a daily audio flash card. This podcast is intended to aid any medical professional preparing for an Advanced Cardiovascular Life Support (ACLS) class. Each one-to-nine minute Flash Briefing-style episode covers one of the skills needed to recognize a stroke or cardiac emergency and work as a high-performing team to deliver quality care. Listening to a tip-of-the-day for 14-30 days prior to a class will help cement core concepts that have been shown to improve outcomes in patients suffering a heart attack, cardiac arrest, or stroke. In addition to the chain of survival core concepts and ACLS algorithms, specific information needed to pass the written exam and megacode following the 2020 guidelines is presented. Healthcare providers that are already ACLS certified may find listening a helpful reminder. Disclaimer: This podcast is a supplement to your course's approved text book and videos - not a replacement. The information presented is for educational purposes only and is not medical advice. Medical professionals should follow their local laws, agency protocols, and act only within their scope of practice. read less

Our Editor's Take

The Pass ACLS Tip of the Day podcast is a great idea. Taking the test that teaches Advanced Cardiovascular Life Support (ACLS) is stressful. There is so much detailed information to master. And when medical personnel resorts to ACLS, they deal with serious health events. Heart attack and stroke are some of the most common. A mistake during such a procedure could prove disastrous.

That's where the Pass ACLS Tip of the Day podcast comes in. Test-takers shouldn't rely upon the podcast as primary instruction. But as an additional resource, it's shown high effectiveness in clarifying complicated concepts. Each entry is usually three or four minutes long and never surpasses ten minutes. The brevity translates to clarity. Only one element of the multifaceted ALCS procedure gets coverage at a time.

Another valuable source of complementary info is the website that accompanies the podcast. PassACLS.com lists host Paul Taylor's favorite relevant health podcast series. He also lists individual podcast episodes that can further help ACLS exam research. Topics include ACLS-related medications, oxygen, tachycardia, and bradycardia.

Taylor is an expert after over 20 years as an ACLS instructor. He's helped hundreds of health professionals pass their ACLS exams. So, fans of the podcast format preparing to take the ACLS test, take note.

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Start Here

Sinus Tachycardia vs. Supraventricular Tachycardia (SVT)

Sinus Tachycardia vs. Supraventricular Tachycardia (SVT)

ECG characteristics of supraventricular tachycardia (SVT) vs. sinus tachycardia. Signs & symptoms that indicate a patient is unstable. Delivery of a synchronized shock for the treatment of unstable SVT using a biphasic vs monophasic defibrillator. Consideration for team safety while performing synchronized cardioversion. Actions to take immediately if an unstable patient we’ve cardioverted goes into a pulseless rhythm. Management of stable patients in SVT. For more on narrow complex tachycardias, check out the pod resource page at passacls.com.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Sinus Tachycardia vs. Supraventricular Tachycardia (SVT)

Sinus Tachycardia vs. Supraventricular Tachycardia (SVT)

ECG characteristics of supraventricular tachycardia (SVT) vs. sinus tachycardia. Signs & symptoms that indicate a patient is unstable. Delivery of a synchronized shock for the treatment of unstable SVT using a biphasic vs monophasic defibrillator. Consideration for team safety while performing synchronized cardioversion. Actions to take immediately if an unstable patient we’ve cardioverted goes into a pulseless rhythm. Management of stable patients in SVT. For more on narrow complex tachycardias, check out the pod resource page at passacls.com.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Epinephrine Administration During Cardiac Arrest

Epinephrine Administration During Cardiac Arrest

When working to resuscitate a patient in sudden cardiac arrest, Epinephrine is the first IV medication we administer. When we give the first dose of epinephrine depends on whether the patient is in a shockable or non-shockable rhythm. When to give the first dose of epinephrine and its frequency for patients in asystole or PEA following the right side of the Adult Cardiac Arrest algorithm.When to give the first dose of epi and its frequency for patients in V-Fib or pulseless V-Tach following the left side of the Adult Cardiac Arrest algorithm. Example chronology of events for a scenario where a patient is found unresponsive, pulseless, and only gasping/agonal breathing. Administration of epi via the IO or endotracheal route in the absence of an IV.The maximum cumulative dose of epinephrine that can be administered to patients in cardiac arrest. When do we stop administering epinephrine.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Identification & Treatment of Common Conditions That Can Mimic a Stroke

Identification & Treatment of Common Conditions That Can Mimic a Stroke

If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it’s possible they could be having a stroke.The Cincinnati Prehospital Stroke Scale uses the acronym FAST to assess Facial droop – Arm Drift - Speech – and Time.There are several conditions that can mimic a stroke.Identification & Treatment of hypoglycemia or hyperglycemia.Identification & Treatment of hypoxia using a pulse oximeter. Some seizures, electrolyte imbalance, sepsis, brain tumors, and Bell’s Palsy can also mimic a stroke.Prehospital providers should transport suspected stroke patients to a stroke center following their local protocols.Hospital providers should active their stroke team to ensure rapid assessment and treatment.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Medication Administration Via Intraosseous or Endotracheal Tube Route

Medication Administration Via Intraosseous or Endotracheal Tube Route

Most ACLS medications are given IV push. But, what happens if we can't get an IV? When IV access isn't available, we should consider administering our IV medications via intraosseous (IO)or endotracheal tube (ETT) route. Why IO is better for than ETT as an alternative route. The locations we should place an IO when running a code and a location we should avoid. The ACLS medications that can be given intraosseous. Where you can find more information about intraosseous access during resuscitation efforts. In the absence of an IV or IO, some medications may be given down the endotracheal tube. The disadvantages of medication administration via ETT. Review of the medications that can be given down the tube and how they should be given. Medications should not be given down the tube when anything other than an endotracheal tube is used as an advanced airway. Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Prehospital Capabilities and EMS Destination Protocols for STEMI & Stroke

Prehospital Capabilities and EMS Destination Protocols for STEMI & Stroke

The chain of survival for a cardiac emergency and stroke start the same:1. preparedness & recognition of an emergency;2. activation of EMS; 3. delivery of Advanced Life Support; and 4. transporting to the most appropriate facility.Depending on where you live, Emergency Medical Services (EMS) may provide prehospital Advanced Life Support (ALS).ALS ambulances are staffed with paramedics who have training in ACLS skills. Paramedics can perform an assessment, obtain a medical history, and provide life-saving care within minutes of recognition.Why EMS "Destination Protocols" for suspected stroke and STEMI make a difference. ACLS’s timed benchmarks for:point of first medical contact to PCI for ST elevation MI;door to tPA for ischemic stroke; andonset of symptoms to EVT for LVO strokes.EMS may bypass a close hospital to transport a STEMI or suspected stroke patient to a hospital capable of 24/7 PCI or a certified stroke center; because time is heart muscle or brain cells.Check out the Pod Resource page at passacls.com for links to the "EMS On Air" podcast for links to episodes that look at EMS's role in stroke outcomes in the rural vs urban area.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Review of Automated External Defibrillator (AED)

Review of Automated External Defibrillator (AED)

Performing good CPR and delivering a shock as soon as possible to a patient in Ventricular Fibrillation or pulseless V-Tach are the two most critical interventions that have been shown to increase survival from sudden cardiac arrest.Studies have demonstrated significantly better out-of-hospital cardiac arrest survival outcomes in communities with robust public CPR training and public access/first responder AEDs.The general use of AED including: indications for use; attaching the AED pads; following verbal prompts; and safely administering a shock.Following the Adult Cardiac Arrest algorithm while using an AED.Contraindications to AED use.General safety considerations to remember.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Asystole & Pulseless Electrical Activity (PEA)

Asystole & Pulseless Electrical Activity (PEA)

For apneic patients without a carotid pulse or pulseless patients with only gasping/agonal respirations, we will follow the Adult Cardiac Arrest algorithm. For pulseless patients that the AED doesn't advise a shock, the patient's ECG shows asystole, or a non-perfusing organized rhythm (PEA), we will follow the right side of the algorithm. Initial steps are aimed at delivery of high-quality CPR to keep the brain and vital organs alive. Epinephrine administration. Placement of an advanced airway.Considering possible reversible H & T causes of cardiac arrest including three common causes of PEA and their emergent interventions.When we should discontinue resuscitation efforts and call the code.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Using Songs to Aid in Delivering Good CPR

Using Songs to Aid in Delivering Good CPR

Providing good, high quality, CPR with minimal interruptions and early defibrillation are two keys to improved cardiac arrest outcomes. A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rate. Characteristics of good songs that will help us.Advantages & disadvantages of using a song during CPR. Selected songs from various genres and time periods from AHA's "Don’t Drop The Beat" playlist on Spotify.https://open.spotify.com/playlist/2mU2FNAhSOtQwW0hBgQMaKConnect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Obtaining a Medical History

Obtaining a Medical History

A patient’s medical history will help us identify things that may be causing (or contributing) to their current condition as well as guide our decisions so we provide the safest evidence-based care possible.Examples of information obtained in a medical history that will impact the treatment we provide. E.g. Not giving nitro to patients taking PDE inhibitors. There are several mnemonics and memory aids that people use to guide their history taking. Review the SAMPLE PQRST medical history format.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Medication Review: Magnesium and Procainamide

Medication Review: Magnesium and Procainamide

Although magnesium can be used in the treatment of other medical conditions such as eclampsia, asthma, & digitalis toxicity; for ACLS, magnesium is primarily used to treat Torsades de Pointes.Identification of torsades on the ECG.Administration of a magnesium infusion for stable patients vs slow IV push for patients in cardiac arrest. Procainamide use for stable patients with a monomorphic wide-complex tachycardia.Procainamide dosing and when to stop the infusion. Tip for determining whether magnesium or Procainamide should be used when treating stable patients with V-Tach.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

H&T Reversible Causes of Cardiac Arrest: Hypovolemia

H&T Reversible Causes of Cardiac Arrest: Hypovolemia

When a patient loses excessive amounts of fluids, we say that they are in a state of hypovolemia.The most obvious cause of hypovolemia is from bleeding.Bleeding can be internal or external and caused by trauma, pathology, or iatrogenic.Classic signs & symptoms of hypovolemic shock.Volume replacement with crystalloids vs blood.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Medication Review: Morphine

Medication Review: Morphine

MONA is the acronym sometimes used to help us remember the interventions to consider for patients with Acute Coronary Syndrome or ACS.Morphine's use in the Acute Coronary Syndrome (ACS) algorithm. Why Morphine is helpful for patients with ACS. Contraindications and considerations for the safe administration of Morphine.Morphine as an alternative to nitro for patients with chest pain that take PDE inhibitors.Common dosing & administration of Morphine.Monitoring of the patient's level of consciousness, pain, blood pressure, and respirations after administration. Possible side effects of Morphine administration.Narcan as an antidote to Morphine if needed.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Maintaining a Chest Compression Fraction (CCF) Above 80%

Maintaining a Chest Compression Fraction (CCF) Above 80%

Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include: Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality.Tips to limit pauses in CPR compressions to 10 seconds or less include:1. Pre-charge the defibrillator for 15 seconds before completion of a 2 minute cycle;2. Continuing chest compressions until the defibrillator is fully charged; 3. Continuing chest compressions during insertion of an advanced airway; and 4. Performing other activities simultaneously during scheduled pauses. Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Medication Review: Epinephrine and Dopamine

Medication Review: Epinephrine and Dopamine

Epinephrine and Dopamine are adrenergic agonist used in several ACLS algorithms. The use of epinephrine for severe anaphylaxis or unstable bradycardia. Review epinephrine’s effects on blood vessels and bronchioles. Why epinephrine is helpful for patients with anaphylaxis. Using an epi drip for unstable bradycardia.Epinephrine administration during cardiac arrest.Starting and epinephrine or Dopamine drip for patients that have ROSC.Review the effects of Dopamine based on mcg/kg/min dosing. Monitoring the patient and titrating epi or Dopamine drips to prevent harm.For more information on ACLS medications, check out the pod resource page at passacls.com.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Delivering Artificial Ventilations

Delivering Artificial Ventilations

Providing rescue breathing to apneic patients with a palpable pulse. Normal end tidal CO2 for patients with a pulse. Identification of cardiac arrest and our immediate actions. Providing artificial ventilations during CPR without an advanced airway vs with an advanced airway in place. Using quantitative waveform capnography to confirm placement of an advanced airway, assess the quality of CPR, and identify ROSC. The effects of hyperventilating patients in cardiac arrest. Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

H&T Reversible Causes of Cardiac Arrest: Hypothermia

H&T Reversible Causes of Cardiac Arrest: Hypothermia

Hypothermic patients aren't dead until they are warm and dead. When a patient’s core body temperature drops below 96.8 F (36 C), they are hypothermic. As the body’s temperature drops below 36 C, hypothermia may further be classified as moderate or severe:Moderate if the patient’s body core temp is between 30-34 C; andSevere if it's below 30 C.Modifying the ACLS Adult Cardiac Arrest algorithm for patients with severe hypothermia. Following the ACLS algorithm for patients with a body core temperature above 30 C. Methods for rewarming patients with moderate vs severe hypothermia. Continuation of CPR and ACLS efforts until the patient’s body core temp is above 36 C.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Medication Review: Calcium Channel Blockers

Medication Review: Calcium Channel Blockers

Calcium is one of the ions that move across the cellular membrane during cardiac contraction and relaxation. The primary use of calcium channel blockers in ACLS is for the treatment of stable, narrow complex tachycardias refractory to Adenosine and to lower the blood pressure of ischemic stroke patients with severe hypertension.Use of calcium channel blockers for SVT refractory to Adenosine and A-Fib or A-Flutter with RVR. Contraindications of calcium channel blockers. Nicardipine use during the treatment of ischemic strokes.For more information on ACLS medications, tachycardia, or stroke check out the pod resource page at passacls.com.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Review of ACLS's Post-Cardiac Arrest Care Algorithm

Review of ACLS's Post-Cardiac Arrest Care Algorithm

While running a code, the thing we hope for is Return of Spontaneous Circulation (ROSC), followed by recovery so the patient can return to a normal life. ACLS's Post-Cardiac Arrest Care algorithm provides us with evidence-based guidance for the initial stabilization phase as well as continued management activities. Our primary focus immediately following ROSC is aimed at ensuring adequate perfusion of the body’s vital organs. Management of O2 and CO2 concentrations. Administration of Atropine for symptomatic bradycardia. Maintaining a systolic BP of at least 90 and MAP of 65 mm Hg or more. Use of Dopamine, Levophed, and Epinephrine drips to maintain blood pressure. Starting targeted temperature management (TTM) for at least 24 hours based on the patient's ability to obey simple commands.Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Medication Review: Nitroglycerine

Medication Review: Nitroglycerine

Nitroglycerine is vasodilator that affects peripheral blood vessels and coronary arteries. Because of its widespread dilation effects on blood vessels, nitro can quickly lower a patient’s blood pressure, sometimes to the point of making a patient hypotensive. Assessment of vital signs prior to administering nitro is necessary to ensure patient safety. Indications for use of nitroglycerine. Nitroglycerine's contraindications & considerations for use. Effects of nitro on patients taking PDE inhibitors.Administration of nitroglycerine to patients with ischemic chest pain. Considerations for patients that took their home nitroglycerine.Monitoring patient's pain and vital signs after nitro administration. Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!

Atrial Fibrillation or Flutter with RVR

Atrial Fibrillation or Flutter with RVR

In atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) the electrical impulse for cardiac contraction is in the atria but isn't the normal pacemaker of the heart, the SA node. The ECG characteristics of A-Fib and A-Flutter. Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR). Suggested energy settings for synchronized cardioversion of stable patients with a narrow complex tachycardia. Team safety when cardioverting an unstable patient in A-FIB.Adenosine’s role for stable SVT patients with atrial rhythms. Treatment of stable patients in A-Fib/Flutter with RVR.For other medical podcasts that cover narrow complex tachycardias, visit the pod resource page at passacls.com. Connect with me:Website: https://passacls.com@PassACLS on Twitter@Pass-ACLS-Podcast on LinkedInGive back & support the show:via PayPal Good luck with your ACLS class!