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Advanced cardiac life support

 

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Advanced cardiac life support



 
 
Advanced cardiac life support or (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.

Extensive medical knowledge and rigorous hands-on training and practice are required to master ACLS. Only qualified health care providers (e.g. physician
Physician

A physician, medical practitioner, doctor of medicine, or medical doctor practices medicine, and is concerned with maintaining or restoring human health through the study, diagnosis, and treatment of disease and injury....
s, paramedic
Paramedic

A paramedic is a medical professional, usually a member of the emergency medical services, who primarily provides pre-hospital advanced Medical emergency and Physical trauma care....
s, nurse
Nurse

A nurse is a healthcare professional, who along with other health care professionals, is responsible for the treatment, safety, and recovery of Acute or Chronic ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings....
s, respiratory therapists, clinical pharmacists and other specially trained health care providers) can provide ACLS, as it requires the ability to manage the patient's airway, initiate IV access, read and interpret electrocardiogram
Electrocardiogram

An electrocardiogram is a recording of the electricity activity of the heart over time produced by an electrocardiograph, usually in a Non-invasive recording via skin electrodes....
s, and understand emergency pharmacology.






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Advanced cardiac life support or (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.

Extensive medical knowledge and rigorous hands-on training and practice are required to master ACLS. Only qualified health care providers (e.g. physician
Physician

A physician, medical practitioner, doctor of medicine, or medical doctor practices medicine, and is concerned with maintaining or restoring human health through the study, diagnosis, and treatment of disease and injury....
s, paramedic
Paramedic

A paramedic is a medical professional, usually a member of the emergency medical services, who primarily provides pre-hospital advanced Medical emergency and Physical trauma care....
s, nurse
Nurse

A nurse is a healthcare professional, who along with other health care professionals, is responsible for the treatment, safety, and recovery of Acute or Chronic ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings....
s, respiratory therapists, clinical pharmacists and other specially trained health care providers) can provide ACLS, as it requires the ability to manage the patient's airway, initiate IV access, read and interpret electrocardiogram
Electrocardiogram

An electrocardiogram is a recording of the electricity activity of the heart over time produced by an electrocardiograph, usually in a Non-invasive recording via skin electrodes....
s, and understand emergency pharmacology. Some health professionals, or even lay rescuers, may be trained in basic life support
Basic life support

Basic Life Support is a level of medical care which is used for patients with life-threatening illness or injury until the patient can be given full medical care....
 (BLS), especially cardiopulmonary resuscitation
Cardiopulmonary resuscitation

Cardiopulmonary resuscitation is an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest. CPR is performed in hospitals, or in the community by layman or by emergency response professionals....
 or CPR. When a sudden cardiac arrest occurs, immediate CPR is a vital link in the chain of survival
Chain of survival

The chain of survival refers to a series of actions that, when put into motion, reduce the mortality associated with cardiac arrest. Like any chain, the chain of survival is only as strong as its weakest link....
. Another important link is early defibrillation
Defibrillation

Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias, ventricular fibrillation and ventricular tachycardia....
, which has improved greatly with the widespread availability of AED
Automated external defibrillator

File:ILCOR AED sign.jpgAn automated external defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of electrical ther...
s.

ACLS is an extension of BLS. It often starts with analysing patient's heart rhythms with a manual defibrillator. In contrast to an AED in BLS, where the machine decides when and how to shock a patient, the ACLS team leader makes those decisions based on rhythms on the monitor and patient's vital signs. The next steps in ACLS are insertion of intravenous (IV) lines and placement of various airway devices. Commonly used ACLS drugs, such as epinephrine
Epinephrine

Epinephrine is a hormone and neurotransmitter.Epinephrine increases the "fight or flight" response of the Sympathetic nervous system of the autonomic nervous system....
 and atropine
Atropine

Atropine is a tropane alkaloid extracted from deadly nightshade , jimsonweed , Mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a hard drug with a wide variety of effects....
, are then administered. At this time, the ACLS personnel quickly search for possible causes of cardiac arrest (e.g., a heart attack
Myocardial infarction

Myocardial infarction , commonly known as a heart attack, occurs when the Blood flow to part of the heart is interrupted. This is most commonly due to occlusion of a coronary artery following the rupture of a Vulnerable plaque, which is an unstable collection of lipids and white blood cells in the wall of an artery....
, drug overdose, or trauma). Based on their diagnosis, more specific treatments are given. These treatments may be medical such as IV injection of an antidote for drug overdose, or surgical such as insertion of a chest tube
Chest tube

A chest tube is a flexible plastic tube that is inserted through the side of the chest into the pleural cavity. It is used to remove air or fluid , or pus from the intrathoracic space....
 for those with tension pneumothoraces
Pneumothorax

In medicine , a pneumothorax, or collapsed lung, is a potential medical emergency caused by accumulation of air or gas in the pleural cavity....
 or hemothoraces
Hemothorax

A hemothorax is a condition that results from blood accumulating in the pleural cavity....
. While the above mentioned ACLS steps are being carried out, it is crucial to continue chest compression with minimal interruptions. This point is emphasized repeately in the new ACLS guidelines (see below)

As the new guidelines acknowledge, only the basic interventions of CPR and early defibrillation have been shown to improve survival from cardiac arrest.

The new Guidelines were published in December 2005 and may be found in Circulation . The major source for ACLS courses and textbooks in the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
 is the American Heart Association
American Heart Association

The American Heart Association is a non-profit organization in the United States that fosters appropriate Heart care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke....
; in Europe, it is the European Resuscitation Council (ERC). An ACLS Provider Manual reflecting the new Guidelines is now available.

External links

  • includes good glossary, and details of heart health
  • includes the new European 2005 guidelines