ACLS CERTIFICATION : IMPORTANT TIPS TO PASS THE ACLS CERTIFICATION LIKE A BOSS CHEAT SHEET GUIDE

what's going on all my healthcare brothers and sisters i hope that you're having a wonderful day it is finally upon us the acls certification 2020 important tips on how to pass your acls like a boss cheat sheet and review let's get started so in order to understand our acls we have to start with our bls our basic life support so that is compressions airway and breathing always c a b in order to understand basic life support in our adults we want to check for responsive responsiveness of our patient by tapping on them firmly on their collarbone hey are you okay if you don't get a response we want to assess the environment for safety we don't want to be doing chest compressions out in the middle of the street right we want to move that potential victim out from the middle of the street into a safe area once we confirm we're in that safe area we want to activate that emergency response system how do we do that we shop for help hey i need help i need help and hopefully another person will come to you if they do you want to have that other person go and get an aed or defibrillator as well as contact 9-1-1 we're going to check for breathing and a pulse no more than 10 seconds this is in red you're probably going to see this on your chest bling bling bling bling make sure that you pay attention to that check for breathing and pulse no more than 10 seconds then we're going to begin our cpr if neither of those things are detected we start our cpr with our chest compressions as well as airway and breathing of course we know that cycle that we do with our bls but if there is a pulse present and there is agonal breathing we want to begin rescue breaths immediately i know this is a little bit difficult because it's 20 20 we're in the midst of a coveted pandemic kind of use your best judgment if you don't want to be breathing into somebody's mouth because you're concerned about kova that's probably not a good idea make sure you at least activate the emergency response system so starting with our chest compressions how do we do chest compressions we want to place the palms of our hands over the patient's sternum just at the xiphoid process just above that now there was a previous indicator that stated that we wanted to place the palm of our hands at the mid nipple line but as we know due to the increase in obesity and morbid obesity the nipple line may actually no longer be a good indicator if they if the nipples aren't where they're supposed to be so we want to at least make sure that we try to find that xiphoid process and put our palms right above it because you can break that cycle process and cause other problems so make sure that you're looking for that sternum chest compressions are 100 to 120 per minute the compression depth in adults is two inches we want to allow for full chest recoil between compressions and we want to minimize those interruptions less than 10 seconds so as you can see in here we got two things in red chest compressions 100 to 100 per minute and we want to allow a minimize interruption sorry for 10 seconds bing bing bang those things are probably going to be on your tests we want to switch compression team members every two minutes that is one cycle every two minutes chest compressions to ventilation ratio in adults it is always 30 compressions to two rescue breaths so moving on to our airway and our breathing we want to utilize the head chin lift if we are not concerned about any trauma to that cervical spine otherwise we're going to use that jaw thrust to make sure that we stabilize that cervical spine if there is trauma related to it rescue breaths are one breath every five to six seconds you want to see that visible chests rise and fall with each rescue breath that you provide we also want to avoid excess ventilation why well there could be potential complications um we could have a reduction of cerebral blood flow related to the decrease in paco2 levels if we're excessively ventilating them then of course we're blowing off a lot of that paco2 right there's also a risk of increased intrathoracic pressure which could lead to adverse hemodynamic effects such as hypotension once that second person finally brings you that aed after you've been doing your chest compressions your airway and your breathing we want to figure out how to use it right so the first thing that we're going to do is we're going to turn the aed on and follow the aed prompts don't start putting pads and things on patients turn it on that's the first thing that you want to do we're going to open or remove the patient's shirt by clearing any wetness or moisture if it's like a drowning patient we don't want that we also want to remove medication patches i just want to say be very careful when you're removing medication patches if you're using your bare hands because whatever's on that medication can absorb into your skin and we don't need that right we're going to attach the aed pads and plug the pads into the connector located on the aed we want to stop chest compressions we want to confirm everybody is clear by saying stand clear because the aed needs to analyze what's going on moving on to step five push that analyze button and allow the aed to analyze the person's heart rhythm if a shock is recommended by the aed we want to again make sure that nobody is touching that patient and we want to repeat stand clear be very direct when you say that you don't want somebody getting a shock when they don't need it once everybody is clear we're going to press that shock button after we press that shot button what did we want to do we're going to begin cpr again immediately start with those chest compressions following that shot if no shock is advised then of course we go back to doing our chest compressions we perform those two minutes of cpr and then we follow the aed's prompts again during the next cycle so we pretty much covered a lot of what the bls wants you to know so let's move on to our aceless and start talking about those rhythms so we have three sets of rhythms that we're really usually concerned about that's our bradycardic rhythms our tachycardic rhythms and our lethal rhythms so let's get started on looking at our bradycardic rhythms starting with sinus bradycardia it's not always a bad rhythm the rate is less than 60 beats per minute the rhythm is usually regulated regular initiated by the sa node p waves are normal and upright the pure interval lengthens as the rate decreases and our qrs interval is usually normal it's less than 0.12 seconds this is normal in our well-conditioned visuals such as like our athletes so we usually don't do anything with this unless the patient is symptomatic moving on to our heart blocks we have a first degree heart block rhythm this is a rhythm that we really want to be cautious with the ray is usually dependent on what the underlying rhythm is it's either usually a sinus rhythm or a sinus bradycardia rhythm is usually regular and our p waves are regular and always precedes each qrs complex the thing that makes this different is the pr interval is greater than 0.2 seconds qrs is always normal it's less than 0.12 and it's the most common rhythm that you'll usually see in the heart blocks it's usually caused by an increased delay at the level of the av node causing a prolongation rather than a real true block so sometimes we do something about this sometimes it resolves itself it's really one of those label rhythms moving on to our next heart block it's getting a little bit worse so we have a second degree heart block type one rhythm so the rate is dependent on what the underlying rhythm is uh the rhythm is usually irregular p waves are usually normal the pr interval usually lengthens so what you'll see in this is that the p wave will lengthen lengthen lengthen and then you have a drop in the rhythm your qrs is less than 0.12 seconds and like i said before the definition of this is lengthening of the pr interval until the impulse is blocked and the qrs drops in this repeated pattern so now we have our second degree heart block type 2 rhythm so the rate the atrial rate is usually faster than the ventricular rate the rhythm is still irregular just like with our second degree type 1 and our p waves are occasionally conducted so the pr interval is usually consistent that's what makes second degree type 1 and second degree type 2 very different is you have consistent pr intervals when you have them the qrs is usually greater than 0.12 seconds usually and that's because there's a block within or below the av junction within the change in conduction ratio so pr intervals never change they can progress to a third degree heart block which is really bad and usually sometimes in these patients we might have to pace them so moving on to that big bad boy rhythm third degree complete heart block so with this one the rate the atria is usually 60 to 100 beats per minute and that ventricular rate is much slower it's usually less than 40 beats per minute so with this rhythm the atria and ventricular rhythms are independently regular and not associated with one another so like in our normal sinus rhythm our p is always preceded by qrs and it's very regular this is still regular but they don't talk to each other they're not communicating right so p waves are normal but there's no relation to the qrs like we discussed before you're not going to see those pr intervals and those qrs intervals are really going to vary so the definition is there's a failure of the atria and the ventricles to synchronize contraction so you're going to have those regular p to p intervals and regular r to r intervals but they're not going to match each other like they should so the atria rate is going to be normal and the ventricular rate is going to be brady so looking at the interventions for our sinus bradycardia that's symptomatic as well as our heart blocks is we're going to start giving atropine sulfate now you're going to really see this more in sinus bradycardia and first degree heart block because with our second degree type 2 and our third degree heart block atropine isn't really something that we rely on to be used it doesn't really show any benefit it doesn't mean that it's not used you can see it used but it just doesn't really show benefit other things is transcutaneous pacing if our medications all the other interventions are not working as well as dopamine and epinephrine so let's go over what each of those are so to start with our atropine it is the first drug of choice for symptomatic sinus bradycardia it could be beneficial as 80 nodal blocks like we discussed earlier it's not really effective in that type 2 second degree as well as our third degree complete heart blocks usually dosing with this is 0.5 milligrams iv every three to five minutes as needed we do not want to exceed 0.04 milligrams per kilogram which is usually a maximum of three milligrams considerations for this it can increase myocardial oxygen demands so we have to be cautious if the patient is experiencing a mitocardial ischemia or if there's some kind of hypoxia present and atropine may cause paradoxical slowing so we have to be prepared to pace these patients in case that atropine goes the other way and makes that bradycardia worse so transcutaneous pacing this is not fun for our patients so when do we use this it's for our unstable bradycardia patients usually their rhythm is less than 50 beats per minute with some kind of compromised hemodynamics what does that mean so that's our hypotension our acute altered mental status shock ischemic chest discomfort as well as our acute heart failure so precautions with this conscious paced patients may require analgesics for pacing discomfort it doesn't feel good nobody wants to be paced especially externally we want to avoid palpating the carotid pulses to confirm capture why is that why do we not want to confirm capture there because electrical impulses cause muscle just jerking that can actually mimic that carotid pulse so we never want to check a carotid pulse move or transcutaneous pacing so how do we set this up so we want to position the pads on the patient as destructed by the packaging usually it's right above the right anterior chest and the mid axillary line on the left side this kind of gives that electricity to that heart so we want to turn on the pacer very important turn it on we want to set the demand rate to 80 beats per minute or whatever the physician orders and we want to set the ma output so an increase in currents starting with a minimum setting is usually where we want to begin until the electrical capture is consistent we're going to see why qrs's and t waves after each pacer spike that means they are ventricular paste so the usually the common current ranges are between 50 to 80 mas is where we're gonna see them when we are effectively pacing our symptomatic bradycardia patients so let's move on to that good old boy dopamine so that is our second drug of choice with symptomatic sinus bradycardia we use this really for hypotension we have a systolic of less than 100 with signs and symptoms of shock this is extremely important that you know i know we push a lot of medications iv push this is one medication that you do not want to push iv push we're always going to provide it via iv infusions so the infusion rate with dopamine is usually between 2 to 20 micrograms per kilogram per minute we titrate based on the patient's hemodynamics their blood pressure we want to titrate that slowly to hopefully help with those hemodynamics so dopamine considerations we need to correct hypovolemia with adequate fluid replacement prior to giving this dopamine we are not iv pushing this this is an infusion so if they don't have that adequate fluid replacement it's not going to go anywhere so we want to correct that first prior to starting this we want to use caution with cardiogenic shock patients with chf it may also cause tachyarrhythmias as well as excessive vasoconstriction so those are things that we need to be on the lookout for and we don't want to mix this medication with sodium bicarbonate because it can't activate the dopamine due to the alkaline solution so we always want to make sure that we're using the appropriate solution when we're mixing this medication for infusion and lastly our epinephrine this is an alternative drug of choice for symptomatic bradycardia in place of dopamine if it's really contraindicated and we can't give it it's used when pacing and atropine fails as well as we have severe hypotension so again this is an infusion so we're giving this it's between 2 to 10 micrograms per minute for the infusion and we're going to titrate based on the patient's hemodynamics just like we did with our dopamine epinephrine considerations raising blood pressure with increasing heart rate can actually cause angina myocardial ischemia as well as an increase in oxygen demand so we have to be very careful when we're titrating this medication high doses do not improve survival rates and it actually may be contributed to post resuscitation myocardial dysfunction with poor neurological outcomes so that's why we don't use it a whole lot um high doses can be required if the patient has some kind of poison or as well as some kind of drug and do shock moving on to our tachycardic rhythm so we start with our superventricular tachycardic rhythm so the rate is usually greater than 150 beats per minute the rhythm is regular and the p waves are often obscured by the t waves so with our pr intervals they're difficult to measure but they're usually normal they're usually between the 0.12 to 2 seconds um qrs intervals are usually less than or 0.12 seconds um it's just a really really extremely fast paced rhythm so what interventions are we going to do for supraventricular tachycardia well oxygen if the patient requires it if the patient is stating um correctly above 94 then obviously we don't need to give oxygen bagel maneuvers is something big that we can try first before we move on to more invasive measures such as our adenosine which stops the patient's heart rate for a moment to re-kind of set that calibration as well as if there is a hemodynamic instability like we talked about before with our hypotension our acute altered mental status changes shock ischemic chest discomfort those things we want to prepare and get the patient ready for synchronized cardioversion so vagal maneuvers that's our first line management tool for tachycardias so what are some things that we can do well we can have the patient cough this creates the same physiological response as bearing down and can be easily performed um the cough must be forceful and sustained if you have a patient that goes that's not a thing they gotta really cough that out just be forceful and sustain cold stimulus to the face ice packs on the face or a washcloth soaked in ice water for about 10 seconds can also be used this creates that same physiological response like submersion and cold water like the diver's reflex carotid massage performed on a patient's necks as well as they are extended and um turned away so if this is the karate that you're going to massage you want their neck ascended and turned away uh only massage that one side for 10 seconds and i highly highly recommend that you don't use this for all patients some patients might have plaque buildup or that might be the only carotid artery that's perfusing the brain we don't know what's happening so we don't use this a whole lot gagging stimulates the vagus nerve by placing a tongue depressor all the way in the back of the patient's throats that might not be the best but that is also another option and lastly bearing down as we know with most of our patients the patient is instructed to bear down just like they're having a bowel movement or they can blow through an occluded 10ml syringe for about 10 i'm sorry about 15 to 20 seconds like we see in the picture here on the powerpoint moving on to our medications adenosine so that is the first drug of choice when we have a stable narrow complex supraventricular tachycardia it may be used for unstable narrow complexes as well just before we get ready for cardioversion if we want to it does not convert atrial fibrillation atrial flutter or ventricular tachycardia those things do not work with adenosine so dosing patient must be placed in a mild reverse chenille brick position so just slightly up um initial bolus is six milligrams giving rapidly over one to three seconds followed by a normal saline of 20 mls and then we want to elevate the extremity that we put it in that way it goes to that heart very quickly if we need a second dose we can give 12 milligrams iv push over one to two minutes if needed just to see if that works and if not the patient's becoming hemodynamically unstable we probably need to move on to cardioversion all right synchronized cardioversion everyone's favorite right not for the patient but it's cool to see regardless so it involves the delivery of a low energy shock which is timed or synchronized to be delivered at a specific point in the qrs complex to avoid causing ventricular fibrillation that's a lethal rhythm we don't want that we don't want to make it worse right so the procedure we want to obtain a 12-lead ecg if the patient is stable so most of the time when we're doing synchronized cardioversions they're not going to be stable so if we can get it beforehand when they are great if not we're not going to delay treatment because of a toilet ecg so we want to prepare proper sedation since cardioversion is very painful and we want to make sure that we have that emergency equipment nearby just in case there is a complication related to the procedure so to begin we want to place the defibrillator pads on the patient and set the monitor to synchronize or sync mode sync mode will deliver that concurrent energy with the qrs making sure that that energy doesn't fall on another part of the rhythm causing ventricular fibrillation we don't want that that is bad we're going to engage the sync mode before each attempt and we're going to look for the sink markers above each r wave so the initial recommendation in regards to voltage doses so if we have a narrow regulator it's going to be between 50 to 100 joules for svt r8 letters narrow irregular 120 to 200 joules if it's a biphasic defibrillator or 200 joules if it's a monophasic defibrillator for atrial fib um why regular is going to be a hundred joules if it's a monomorphic ventricular tachycardia and if we have a ride irregular at that point we're just going to the defibrillation dose we're not playing games this isn't a synchronized cardioversion time we're going to defibrillate so we want to clear our personnel from the bed just like we do with our aed and bls we're going to press that charge button clear the patient make sure the patient's clear we're going to press shock after that shock rhythm we're going to assess the patient's rhythm for additional shocks or if there's any kind of complications begin emergency procedures so let's talk about our lethal mack daddy's shockable rhythms so our first shockable rhythm is pulse's ventricular tachycardic rhythm so that rate is usually between 100 and 220 beats per minute it's regular they're you're not going to see p waves they're not apparent and our qrs are why they're ugly they're disgusting right this is what our pulseless ventricular tachycardia looks like so it usually is three or more pvcs in a row that is either non-sustained less than 30 seconds or is sustained more than 30 seconds um adequate blood pressure is difficult to sustain due to that rapid rhythm and it can lead to ventricular fibrillation if it is not addressed our next shockable rhythm is our ventricular fibrillation um the rate isn't measurable the rhythm is irregular i mean you look at it it just looks like artifact but it's not uh p waves are not apparent pr intervals where are those at i have no idea and our qrs are just those fibrillation waves our ventriculars are just doing this they don't know what's going on so definition multiple foci within the ventricular are rapidly firing repeatedly causing this disorganized ventricular contraction this is one of the three ecg patterns that are usually seen with our cardiac arrest patients so interventions you walk into this patient's room they're either pulses ventricular tachycardia or they are having ventricular fibrillation what is the first thing we're going to do we're going to call for help i need help in here i need help we're going to start providing our cpr and we're going to follow these acls guidelines now what is that we're going to defibrillate we're going to give our epi and then we have other options such as amiodarone or lidocaine in case that epinephrine doesn't work so the first thing we're going to do with our shockable rhythms is defibrillation we always want to use fibrillation with these rhythms if ventricular fibrillation or pulses ventricular tachycardia are present we're going to continue chest compressions without interruptions and we're going to get ready for a shock so what is the defibrillator procedure so we're going to turn on the defibrillator first just like with our aed turn it on first right that's step number one with our biphasic we're going to use the manufacturer guidelines that's usually between 120 to 200 joules and with our monophase if we're going to use 360 joules we're going to place the adhesive pads on the patient like we said before one pad is going to go on the right anterior chest wall as well as the second pad is going to go on the left mid axillary position so we're going to announce the team we're charging the defibrillator and then we're going to press the charge button when the defibrillator is fully charged we want to verify that all of our team members are clear by announcing the shock once the team announces all clear and we have verified that the team is all clear nobody is touching the patient and nobody is touching the bed we're going to call all clear and then press the shock button on the defibrillator we want to make sure nobody gets shocked that doesn't need to be immediately after the shock we're going to resume our cpr for at least five cycles and then we're going to reassess our rhythm so we get epinephrine that's our first stretch of choice for our shockable rhythms so dosing for cardiac arrest iv or io because we can have either access we're going to give one milligram of 10 ml of 1 to 10 000 solution we're going to administer it every 3 to 5 minutes during resuscitation we want to follow each dose with 10 ml flush and we want to elevate the arm for 10 to 20 seconds after each dose we want to get that medication to that heart as quickly as we can if by chance you have a patient that is on a beta blocker or they have a calcium channel blocker overdose either overdose for a beta blocker or the calcium channel blocker we're going to get higher doses of 0.2 milligrams per kilogram because they're gonna need it since their heart isn't functioning appropriately based on these medications amiodarone uh it can cause toxicity it's used in patients with our life-threatening arrhythmias it's usually administered um with sufficient monitoring we want to make sure we continue to monitor these patients if we do give it um we first dose is going to be 300 milligrams iv or io push our second dose is going to be 150 milligrams iv or io push and we don't want to give more than 450 milligrams over a 24 hour period so we want to make sure that we're monitoring these patients for any kind of complications and lastly lidocaine you might not see it a whole lot but it is not part of the acls and i have seen it used in different codes so lion king is considered immediately after we have ross that's a return of spontaneous circulation from ventricular fibrillation as well as pulseless ventricular tachycardia during cardiac arrest and it also can be an alternative to amiodarone during cardiac arrest so the initial dose when we are giving this to our patient is one to 1.5 milligrams per kilogram iv your io refractory ventricular fibrillation sometimes you're going to see that with your codes you can give an additional dose of 0.5 to 0.75 milligrams per kilogram iv push every 5 to 10 minutes we really really don't want to give more than three doses or a total of three milligrams per kilogram with lidocaine it can cause complications we don't want that complications are bad um iv maintenance dosing after when we have ross can usually be between one to four milligrams per minute or usually 30 to 50 micrograms per kilogram per minute and lastly we're moving on to our non-shockable rhythms that's our a sicily and our pea our pulseless electric activity so rate rhythm p waves pr interval qrs interval and in sicily we don't have jack the heart is just not working it has ceased all functionality and electricity and we just have a flat lined patient so lastly pulses electrical activity or pea so everything looks normal you're looking at the rhythm you see the rhythm all right the patient looks okay you go and touch your patient they don't have a pulse that is the big thing with pea so they're going to have an organized cardiac electrical activity but there's going to be absolutely no pulse so what is our intervention with our non-shampoo rhythms we can't defibrillate these patients there's no rhythm to shock so really what are we going to do we're going to call for help hey i need help in here danger danger i'm i'm an adult and i'm alone i need help we're going to provide cpr and we're going to follow our acls guidelines the only medication we can really give for these patients is epinephrine so with all of our acls interventions we really want to consider our h's and our t's when determining what the underlying cause is that's causing all of these massive issues so all their h's we have hypoxemia hypovolemia we can have hydrogen ions like more acidosis happening in the patient hypo or hyperkalemia and hypothermia when it comes to ortiz we have toxins tamponades specifically cardiac tamponade tension pneumothorax we could have a popped lung thrombosis either of pulmonary or coronary descent if we did an amazing job at acls which i know that you all are going to do that we're going to start looking at our post cardiac arrest return of spontaneous circulation ross so what does that mean we want to maintain oxygenation of greater than 94 if they are not maintaining that we want to give our give them some oxygen right we want to treat hypotension we want to keep that systolic blood pressure greater than 90. we're going to get our 12 lead ecg to see what rhythm they're in so we can see where we're going in regards to interventions and we're going to start temperature therapy immediately and we're going to continue rechecking therapy effectiveness every 24 hours i'm going to briefly touch on acute coronary syndrome because i could go on about this all day long but what you need to know for acls is what the immediate emergency treatment is so we're going to obtain a 12 lead ecg we're going to provide oxygen if their oxygen is less than 94 we're going to give aspirin 160 to 325 milligrams if there are not any contraindications we also want to give pain control such as morphine that's a big one you'll see as well as nitroglycerin sublingual or spray now this is contraindicated in patients with right ventricular acute myocardial infarction because we really need that function of that heart if we're giving nitro we're just going to continue to dilate it if it's already having issues we don't want that and with our sexual enhancement drugs such as cialis and viagra it can actually cause worsening hypotension we don't need that we have enough problems going on there's four guys having an mi we don't need that so with our semi patients what you need to know specifically for them is the door to balloon time for pci is usually 90 minutes and our door to needle time for fiber analysis goals are usually 30 minutes now i'm not going to bore you with all the acls dynamic team information but what you really need to know for the test is that if a person is given an assignment outside of their scope of practice or they are not knowledgeable in the assignment that they were provided that it is that person's responsibility to ask for another role you don't just reassign your role without speaking to the team lead if you are uncomfortable with that you need to ask for another role closed-loop communication repeating what the person has called and advised um once something is completed is highly recommended with our teams if the physician says pull up one milligram of epinephrine you say pulling up one milligram of epinephrine when we're giving it we're going to say give the epinephrine giving one milligram of epinephrine it's always that closed-loop communication acls stroke guidelines we want to give fibrinolytic treatment immediately as soon as we know that they are having an ischemic stroke as long as there's no contraindications obviously we're not giving this for hemorrhagic strokes a ct scan when no contrast needs to be performed immediately upon arrival because if it is a hemorrhagic stroke we don't need to make that bleeding worse so ct without contrast for our acls guidelines from regards to stroke lastly we're going to move on to a little bit of our mega codes so with mega code we're always going to begin with our basic life support guidelines with our cad our compressions airway and breathing but what do we start with with acls we have our primary survey and our secondary survey so with our primary survey abcde we're going to begin with a airway so we want to maintain airway patency in conscious patients we don't want the tongue getting in the way causing hypoxemia we want to use an advanced airway if needed we're going to confirm that cpr ventilation and the securement device is in place and we also want to monitor airway placement with continuous quantitative waveform capanography that's a little thing we usually put on the end that'll turn colors to confirm that there is active co2 and we're not sitting in the stomach so with breathing the b we're going to give supplementary oxygen as needed 100 oxygen to our cardiac arrest patients and we're going to titrate oxygen for our stable patients we want to avoid that excess ventilation and it is important if they're having agonal gas these are not normal these are first signs of an impending cardiac arrest we want to start cpr immediately or start rescue breaths depending on where we're at ding ding ding ding these are things that are probably going to be in your chest make sure that you know these so moving on to our c that is for circulation we're going to monitor cpr quality we're going to minimize those interruptions and checking for a pulse no more than 10 seconds if a person performing cpr starts to provide an effective chest compressions we want to give constructive feedback hey you need to push a little faster you need to push a little harder we're going to attach the monitor defibrillator in aed the first step when using aed defibrillator or the monitor is you want to turn it on and you're going to follow the prompts we're going to obtain that iv io access we're going to give the appropriate medications through those accesses we're going to check glucose levels temperature capillary free fill make sure that we're perfusing appropriately and lastly we want to make sure that blood pressure is at a minimum of 90 systolically so that we know that we're perfusing the body so our last two dna disability and exposure in our primary survey of acls disability we're going to check for the neurological function we want to quickly assess for responsiveness such as our level of consciousness and pupillary dilation we're going to use afu which stands for alert is the patient alert v verbal stimulus do they respond to only verbal stimuli p do they only respond to painful stimuli or you are they unresponsive with our exposure we want to remove all of their clothing we want to assess for signs of trauma bleeding burns any kind of abnormal markings or any kind of medical alert bracelet that way we're treating our patients appropriately and lastly we're moving on to our secondary survey what we use we use the sample mnemonic so we begin with signs and symptoms so objective information from either the family or ambulance what happened before the event allergies is our a allergic to food medications and kind of environmental allergies m medications over-the-counter medications vitamins supplements prescribed medications any medications that are not prescribed that may have been ingested or used by the patient past medical history so are we looking at previous illnesses that could be caused for this on previous hospitalizations prior to the event last meal or liquids consumed so what and when was the last meal and liquid consumed and lastly events what led up to the current presentation of our patient i hope that this video is helpful in passing your acls like a boss please go back and review my initial video it's going to be a link up here in the corner i want you to review because it's going to include a lot of the stuff that you're going to see in your text what this updated 2020 version was was giving you that meat and potatoes of aclx did we cover everything that they're going to discuss with you no but we covered the important things that you need to know to pass your exam as well as your mega code if you have any questions please feel free to leave them down below i love answering them make sure that you check out my website at www.nursechung.com i'm going to have links to the acls guidelines there as well as a copy of this powerpoint and a cop and a couple page copy of what you need to know for the exam whatever works best for you make sure you follow me on my social media i'm on facebook instagram and twitter as well as here on youtube and i look forward to seeing you all again and have a wonderful day bye

Channel: Nurse Cheung

Views: 203,742

Keywords: nursing, nursing school, registered nurse, rn, ACLS certification, ACLS recertification, bls certification, tips for ACLS certification, bls recertification, tips for bls certification, tips for acls, tips for bls, American heart association, aha, aha tips, tips acls, tips bls, aha certifications, how to pass ACLS and bls, how to pass acls and bls certifications like a boss, nursing tips, how to pass acls, how to pass acls and bls certifications, tips for acls certification

Id: mHDiAFB6LzI

Length: 35min 47sec (2147 seconds)

Published: Sun Aug 30 2020