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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.
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]
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 two "shockable" rhythms are ventricular fibrillation and pulseless ventricular tachycardia, while the two "non-shockable" rhythms are asystole and pulseless electrical activity. [65] Moreover, in the post-resuscitation patient, a 12-lead EKG can help identify some causes of cardiac arrest, such as STEMI which may require specific treatments.
Defibrillation is effective only for certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia, rather than asystole or pulseless electrical activity, which usually requires the treatment of underlying conditions to restore cardiac function. Early shock, when appropriate, is recommended.
Defibrillation is often an important step in cardiopulmonary resuscitation (CPR). [6] [7] CPR is an algorithm-based intervention aimed to restore cardiac and pulmonary function. [6] Defibrillation is indicated only in certain types of cardiac dysrhythmias, specifically ventricular fibrillation (VF) and pulseless ventricular tachycardia.
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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