Ridryder911
EMS Guru
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After reviewing the new ACLS guidelines :blink: Here are some of the recommendations for "hospital use".. hmm they didn't address EMS as of yet for ACLS.
Agressive CPR with good depth .. at a rate 100/min ventillations 8-10 minute. is the main key !
(If the patient is monitored) No longer stair stacks shocks .. initial rhythm V-fib.. then shock at 360 (monophasic) and 200 (bi-phasic) or whatever has been proven to be successful on that monitor. Then aggressive CPR for at least 5 cycles/ventilation's = 2minutes.
Then check rhythm, pulse .. now give the medication.. either 1 dose of Vasopressin instead of the 1'st or 2'nd dose of Epi. If you choose Epinephrine then continue every 3-5 minutes (as usual). They do stress that administration of medications should be orchestrated with pulse checks.
Airways devices should be installed after aggressive CPR has been performed and up to > 5 minutes before secure airway is okay.
LMA & Combitube are allowable and are recommended as long as you can continuously monitor placement such as ETC02 or Colormetric Co2 can be utilized.
VF or VT after 2-3 shocks Cordorone should be administered; you can use Lidocaine still .. & no there is no change in morbidity & mortality ( but their still pushing Corodorne)
IV or I/O is prefferredover ETT route of medications. ( Better buy stock in the FAST or EZ I/O now !)
Post- Resuscitation-- needs to support myocardial & organ functions
Be sure to closely monitor B/P
Temperature .. too cold or to hot...
Glucose usage in the body
and yes lowering the body to hypothermic level can be successful ** however more research needs to be performed!**
Recommendation of pre-hospital XII lead is endorsed to reduce door to drug or cath lab time.
EMT's should be allowed to administer ASA to patients with chest pain that do not have allergies or GI problems
Stroke- tPA is strongly suggested in ischemic strokes, if CLEARLY DEFINED PROTOCOLS are used
Stroke units can increase outcome
Now this one I thought was weird stating... Medical Emergency Team (MET) shows promising benefits but; cannot be recommended at this time
I am sure there will be more clarification with time for the pre-hospital phase of ACLS... I really recommend listening to the videos until we have the books published. PALS also has some new recommendations as well..
Be safe,
R/R/ 911
Agressive CPR with good depth .. at a rate 100/min ventillations 8-10 minute. is the main key !
(If the patient is monitored) No longer stair stacks shocks .. initial rhythm V-fib.. then shock at 360 (monophasic) and 200 (bi-phasic) or whatever has been proven to be successful on that monitor. Then aggressive CPR for at least 5 cycles/ventilation's = 2minutes.
Then check rhythm, pulse .. now give the medication.. either 1 dose of Vasopressin instead of the 1'st or 2'nd dose of Epi. If you choose Epinephrine then continue every 3-5 minutes (as usual). They do stress that administration of medications should be orchestrated with pulse checks.
Airways devices should be installed after aggressive CPR has been performed and up to > 5 minutes before secure airway is okay.
LMA & Combitube are allowable and are recommended as long as you can continuously monitor placement such as ETC02 or Colormetric Co2 can be utilized.
VF or VT after 2-3 shocks Cordorone should be administered; you can use Lidocaine still .. & no there is no change in morbidity & mortality ( but their still pushing Corodorne)
IV or I/O is prefferredover ETT route of medications. ( Better buy stock in the FAST or EZ I/O now !)
Post- Resuscitation-- needs to support myocardial & organ functions
Be sure to closely monitor B/P
Temperature .. too cold or to hot...
Glucose usage in the body
and yes lowering the body to hypothermic level can be successful ** however more research needs to be performed!**
Recommendation of pre-hospital XII lead is endorsed to reduce door to drug or cath lab time.
EMT's should be allowed to administer ASA to patients with chest pain that do not have allergies or GI problems
Stroke- tPA is strongly suggested in ischemic strokes, if CLEARLY DEFINED PROTOCOLS are used
Stroke units can increase outcome
Now this one I thought was weird stating... Medical Emergency Team (MET) shows promising benefits but; cannot be recommended at this time
I am sure there will be more clarification with time for the pre-hospital phase of ACLS... I really recommend listening to the videos until we have the books published. PALS also has some new recommendations as well..
Be safe,
R/R/ 911
