How to Use Master ACLS How to get the most out of this website! Fast Review or In-depth study
In-Depth ACLS Videos Full length video lectures covering the prerequisite ACLS knowledge
ACLS Acronyms Crack the code for the ACLS Acronyms
Changes to ACLS Algorithms in 2015-2020 Covers the 2015 Guidelines & the 2017 Update to the 2015 Guidelines
2018 Update to the AHA/ILCOR Guidelines Summary of the 2018 Updates to the AHA Guidelines
ACLS Pharmacology Complete coverage of ACLS drugs including Drug Quick Facts
Basic Life Support BLS the foundation for all ACLS
Respiratory Distress and Arrest How Respiratory Distress contributes to & causes Cardiac Arrest
Acute Coronary Syndrome Causes & treatments for cardiac ischemia
Acute Stroke Stroke symptoms, testing, & treatments
Cardiac Arrest Algorithm Causes of cardiac arrest and how to treat them
Bradycardia Algorithm Identify when to treat a slow heart beat & how & when to treat it
Tachycardia Identify when to treat a fast heart beat & how & when to treat it
Care Of the Patient After Return of Spontaneous Circulation (ROSC) You've got a pulse, what now?
Additional Learning Resources Flashcards for fast learning
Defibrillation vs. Syncrhonized Cardioversion Electrical therapies--which one to use and how to use them
ACLS Megacode Practice Scenarios Learn to be a great Megacode Team Leader with NO STRESS
- ACLS Practice Megacode Scenarios
- ACLS Megacode Scenario 1
- ACLS Megacode Scenario 2
- ACLS Megacode Scenario 3
- ACLS Megacode Scenario 4
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- ACLS Megacode Scenario 15
- ACLS Megacode Scenario 16
- ACLS Megacode Scenario 17
- ACLS Megacode Scenario 18
- ACLS Megacode Scenario 19
- ACLS Megacode Scenario 20
- ACLS Megacode Scenario 21
ACLS Video Simulation Learning Center Megacode Videos for ACLS Simulation Learning--fast paced & fun!
ACLS Practice and Final Exams Hundreds of practice test questions. Retake as often as needed!
Care of the Patient After Return of Spontaneous Circulation (ROSC)
After ROSC Management
After ROSC routine use of beta-blockers is not currently recommended. However, for patients who had cardiac arrest due to VF/pVT either initiation or continuation of either an oral or IV beta-blocker may be considered.
It is reasonable use Lidocaine as an alternative antiarrhythmic to Amiodarone when circumstances make administration of Amiodarone unwise or unavailable. Lidocaine may also, be reasonably used after ROSC to prevent recurrent VF/pVT.
Targeted Temerpature Management
Hypothermia therapy is now called Targeted Temperature Mangement TTM. Patients who show signs of neurological impairment such as a change in LOC, are comatose, or even just unable to follow commands correctly should receive TTM. A single target temperature between 32°C and 36°C should be chosen and maintained for 24-72 hours. Variations in temperature up or down have been shown to be associated with poorer outcomes. Even after 24-72 hours when the patient is returned to normal temperature efforts should be made to avoid a fever for at least 7 days, as fever during this time has been shown to be associated with poorer outcomes.
Goals for Hemodynamic status after ROSC
After ROSC hypotension should be avoided by immediate administration via IV or IO of appropriate volume expanders. Systolic blood pressure should be maintained at 90 mm Hg or greater and the mean arterial pressure should be maintained at 65 mm Hg. Studies have shown that less than these pressure have been associated with negative outcomes after ROSC. Studies have also shown that systolic pressure greater than 100 mm Hg were associated with positive outcomes after ROSC.