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Advanced cardiac life support, advanced cardiovascular life support (ACLS) refers to a set of clinical guidelines established by the American Heart Association (AHA) for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused cardiac arrest, using advanced medical procedures, medications, and techniques.
Providers should follow the AHA's Pediatric Tachycardia With a Pulse Algorithm. As always, provides need to support airway, breathing, and circulation and begin CPR if needed. Management of tachyarrhythmias depends on if the child is stable or unstable (experiencing cardiopulmonary compromise: signs of shock, hypotension, altered mental status).
The core algorithm of ALS that is invoked when cardiac arrest has been confirmed, Advanced Cardiac Life Support (ACLS), relies on the monitoring of the electrical activity of the heart on a cardiac monitor. Depending on the type of cardiac arrhythmia, defibrillation and/or medication may be administered.
The management of tachycardia depends on its type (wide complex versus narrow complex), whether or not the person is stable or unstable, and whether the instability is due to the tachycardia. [10] Unstable means that either important organ functions are affected or cardiac arrest is about to occur. [ 10 ]
In synchronized cardioversion, a similar approach is utilized in that electrical current is applied to correct an arrhythmia, however this is used in cases where a pulse is present but the patient is hemodynamically unstable, such as supraventricular tachycardia. Defibrillators may also be used as part of post-cardiac arrest management.
Most adults who can be saved from cardiac arrest are in ventricular fibrillation or pulseless ventricular tachycardia, which means their heart has fallen out of rhythm. [14] Early defibrillation is the link in the chain most likely to improve survival since defibrillation can help shock the heart back into a regular beat. [ 15 ]
It is hemodynamically unstable and causes a sudden drop in arterial blood pressure, leading to dizziness and fainting. Depending on their cause, most individual episodes of torsades de pointes revert to normal sinus rhythm within a few seconds; however, episodes may also persist and possibly degenerate into ventricular fibrillation , leading to ...
Defibrillation [21] — Defibrillation is the definitive treatment step for those cases of cardiac arrest that involve a shockable rhythm, or one correctable by defibrillation (pulseless unstable ventricular tachycardia, coarse or fine ventricular fibrillation; it will not work for asystole or pulseless electrical activity)
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