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What are the 9 cases in ACLS?



Advanced Cardiovascular Life Support (ACLS) can be learned through either traditional classroom instruction or in a hybrid format known as blended learning. All of the different ACLS course options result in the same AHA ACLS Course Completion Card and teach the same science-based techniques from the American Heart Association.

Pulseless Ventricular Tachycardia and Ventricular Fibrillation

Both pulseless ventricular tachycardia (VT) and ventricular fibrillation (VF) are life-threatening cardiac rhythms that lead to inefficient ventricular contractions. VT and VF are abbreviations for ventricular tachycardia and ventricular fibrillation, respectively. In patients with VF, the motion of the ventricles is not coordinated with the contractions of the atrium. A condition known as VT or VTach occurs when the ventricles contract at a rate greater than 100 times per minute.

VF, also known as VFib, is an irregular heart rhythm in which the ventricular walls tremble rapidly and cannot pump blood effectively. Pulselessness in ventricular tachycardia (also known as pulseless VT) is a life-threatening syndrome that happens when ventricular contractions are so rapid that there is no time for the heart to refill, leading to the absence of a detectable pulse. In either scenario, an inadequate amount of blood flow is delivered to the body’s tissues. The ACLS therapy of pulseless VT and VF are substantially the same. This is the case even though VT and VF are separate clinical conditions with different ECG rhythms. The BLS Survey is the first step in the resuscitation process for both pulseless VT and VF.

Pulseless Electrical Activity (PEA) & Asystole

Asystole and pulseless electrical activity (PEA) are related heart rhythms that are both unshockable and life-threatening. PEA stands for pulseless electrical activity. A patient with asystole will have a completely flat ECG. There is no detectable electrical activity in the heart, but there may be a slight deviation from the baseline (referred to as a drifting flat-line). Always double-check to be sure that an asystole reading is not the result of a human or technological error. Verify that the pads are making solid contact with the individual, that the leads are connected, that the gain is properly adjusted, and that the power is on. Without a discernible pulse, PEA is one of the numerous waveforms seen on an electrocardiogram (ECG), including sinus rhythm. Any pulseless waveform, except VF, VT, and asystole can be included in a PEA recording.

PEA is almost always brought on by two conditions: hypovolemia or hypoxia. They are also the ones that can be reversed with the least amount of effort and should be considered first in any differential diagnosis.

Move on to providing post-cardiac arrest care for the individual if they have a return of spontaneous circulation (ROSC).

Cardiac Arrest Management

Care following a cardiac arrest should be initiated as soon as possible for a patient who has a return of spontaneous circulation (ROSC). The initial BLS and ACLS procedures are intended to save the patient’s life. In contrast, post-cardiac arrest care is intended to maximize breathing and circulation, maintain the necessary blood glucose levels, and preserve the heart and brain tissue and function. Pay careful attention to oxygenation, controlling blood pressure, determining whether or not a percutaneous coronary intervention is necessary, and maintaining the optimal temperature.

Because recovery following a cardiac arrest episode continues long after the first hospitalization, the 2020 ILCOR Guidelines urge formal assessment and assistance for an individual’s persistent physical, cognitive, and psychosocial requirements. After a resuscitation episode, remember to treat the mental health needs of the First Responders as well, and plan a debriefing for lay rescuers, EMS personnel, and hospital-based healthcare workers.

Tachycardia 

Tachycardia is the medical term for the condition when the heart beats at a rate greater than 100 times per minute. When the heart beats abnormally rapidly, the relaxation phase lasts for a shorter amount of time. This is typically brought on by one of two basic issues: either a decrease in blood supply to the heart due to the ventricles’ inability to completely fill with blood or a drop in cardiac output due to the ventricles’ inability to completely fill with blood.

Acute Coronary Syndrome 

Acute coronary syndrome include unstable angina, ST-elevation myocardial infarction (STEMI), and non-ST-elevation myocardial infarction (NSTEMI). ACS is an abbreviation for the acute coronary syndrome (NSTEMIA). The onset of acute coronary syndrome can be preceded by several symptoms, including severe chest pain, irregular breathing, pain that spreads to the jaw, arm, or shoulder, profuse sweating, and/or feelings of nausea or vomiting. It is important to remember that these findings are not present in every patient, particularly women and those diagnosed with diabetes mellitus. Because a cardiac event cannot be defined only on ACS symptoms, the management of ACS symptoms must remain consistent.

People displaying these symptoms need to be investigated and watched closely as soon as possible. If you find yourself in a situation with an unconscious person, you should begin by consulting the BLS Survey and then proceed to the appropriate next steps for advanced medical care.

Acute Stroke (Sudden Stroke) Signs & Symptoms

A stroke is caused when there is an abnormality in blood flow to the point that it prevents blood from flowing to the brain. This event is what leads to a stroke. Ischemic and hemorrhagic strokes are the two types of strokes that are commonly discussed. Ischemic strokes occur when a blood clot forms within the brain’s blood vessels, preventing blood from passing through the vessel in question. The incidence of ischemic stroke accounts for 87 percent of all cases, while hemorrhagic stroke accounts for just 13 percent of all cases. In most cases, the symptoms of a transient ischemic attack and a stroke are interchangeable. The treatments themselves are what differentiate one another from another.

Symptomatic Bradycardia-Slow Heart Rate

The condition known as bradycardia occurs when the heart beats at a pace lower than sixty times per minute. Even while a heart rate of fewer than 60 beats per minute is technically recognized to be bradycardia, this isn’t necessarily a cause for concern all the time. Sinus bradycardia can affect anyone, even those in excellent physical condition. Bradycardia is frequently accompanied by symptoms such as tightness in the chest, shortness of breath, lightheadedness, and/or confusion. Other symptoms that may accompany bradycardia include pulmonary edema and congestion, irregular rhythm, and low blood pressure.

On the other hand, the ACLS Survey needs to be performed when bradycardia symptoms are present. If this condition is asymptomatic but still occurs within the arrhythmia illustrated in the next sections, rhythm abnormalities can be readily addressed by visiting a cardiologist. If this condition is symptomatic, however, it will be treated differently.

Sinus Tachycardia

It is a condition in which the body sends out electrical signals that cause the heart to beat more quickly. It can be triggered by strenuous exercise, anxiety, certain medicines, or even a fever. Inappropriate sinus tachycardia is the term used to describe the condition when it occurs for no apparent reason (IST).

It only takes a little stress to drive your heart rate. Or it could be low while you’re just sitting there doing nothing. The incidence of IST is highest in women in their 30s. The symptoms may persist for several months or even years. It’s possible that at first, you won’t see it.

Respiratory Arrest

The absence of breathing is all that is required to diagnose respiratory arrest. It can develop due to respiratory distress, respiratory failure, or other circumstances, such as a severe head injury or drowning.

After the patient has been evaluated and determined that they are experiencing respiratory arrest, the patient must undergo proper respiratory arrest care, which demands that numerous things occur simultaneously. Help needs to be solicited so that other interventions can be carried out. The airway needs to be opened, bag-mask ventilation needs to be carried out, and planning for an advanced airway needs to get underway.

The patient’s airway should be opened, and then a bag-valve-mask apparatus should be used to give positive pressure ventilation. If the patient does not have an injury to their neck or spinal cord, you should be able to open their airway by tilting their head back and lifting their chin. The jaw thrust method can open the airway even when there is a risk of harm to the neck or spinal cord.

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