ACLS Study Guide

Reflecting the 2010 Emergency Cardiovascular Care guidelines, ACLS Study Guide, 4th Edition offers a complete, full-color overview of advanced cardiovascular life support. An easy-to-read approach covers everything from airway management and rhythms and their management to electrical therapy, acute coronary syndromes, and acute stroke. In addition to the latest ACLS treatment algorithms, this edition includes new case studies, new photos and illustrations, a heart rate ruler, and a handy ACLS quick-reference card for use in the field. Written by Barbara Aehlert, ACLS Study Guide is the official textbook for the American Safety & Health Institute ACLS certification course.

• A pretest and posttest -- each containing 50 questions with answers and rationales -- allow you to check your knowledge prior to and after your study.
• Chapter objectives preview the main points in each chapter.
• Stop and Review sections at the end of the chapters help you remember the most important information.
• ACLS Pearls boxes offer key points and useful tips for clinical practice.
• Keeping it Simple boxes provide essential information in a clear and concise manner.
• Ten case studies present real-life clinical situations, allowing you to make decisions based on information in the Preparatory section.
• Consistent format of case studies includes Objective, Skills to Master, Rhythms to Master, Medications to Master, Related Text Chapters, Essential Actions, and Unacceptable Actions.
• A heart rate ruler is included to help you interpret ECGs.
• 4 x 6 pocket-size quick-reference card contains key ACLS algorithms for field use.

• 100 new and updated photos and illustrations show key ACLS procedures and equipment.
• Pharmacological interventions are integrated into the chapters for a more cohesive learning experience.
• New streamlined approach reduces the number of pages and simplifies the information you need to know.

Pretest

Pretest Answers

PART I: PREPARATORY

1. The ABCDs of Emergency Cardiovascular Care

Introduction

Risk Factors for Coronary Artery Disease

Sudden Cardiac Death

Chain of Survival

- Early Recognition and Activation

- Early CPR

- Early Defibrillation

- Early Advanced Cardiac Life Support

- Integration of Post-Cardiac Arrest Care

Phases of Cardiopulmonary Resuscitation

Patient Assessment

- Scene Safety

- General Impression

- Primary Survey

- Secondary Survey

Stop and Review

Stop and Review Answers

2. Airway Management: Oxygenation and Ventilation

Anatomy of the Respiratory System

- Upper Airway

- Lower Airway

Lung Volumes and Capacities

- Lung Volumes

- Lung Capacities

- Ventilation Rates

Devices for Assessing Oxygenation and Ventilation

- Pulse Oximetry

- Carbon Dioxide Monitoring

Oxygen Delivery Devices

- Nasal Cannula

- Simple Face Mask

- Partial Rebreather Mask

- Nonrebreather Mask

Manual Airway Maneuvers

- Head Tilt-chin Lift

- Jaw Thrust

- Jaw Thrust without Head Tilt

Suctioning

- Purpose of Suctioning

- Suction Catheters

- Upper Airway Suctioning

- Lower Airway Suctioning

Airway Adjuncts

- Oral Airway

- Nasal Airway

Techniques of Positive Pressure Ventilation

- Mouth-to-Barrier Device Ventilation

- Mouth-to-Mask Ventilation

- Bag-Mask Ventilation

Advanced Airways

- Esophageal-Tracheal Combitube

- King Laryngeal Tube Airway

- Laryngeal Mask Airway

- Tracheal Intubation

Stop and Review

Stop and Review Answers

3. Rhythms and Management

Introduction

Section 1: Anatomy Review and Basic Electrophysiology

Coronary Arteries

Basic Electrophysiology

- Myocardial Cell Types

- Properties of Cardiac Cells

- Cardiac Action Potential

- Refractory Periods

- Conduction System

The Electrocardiogram

- Electrodes

- Leads

- Electrocardiogram Paper

- Waveforms and Complexes

- Segments and Intervals

Rhythm Recognition

- Sinus Rhythm

- Sinus Arrhythmia

Section 2: Tachydysrhythmias: Too Fast Rhythms

Narrow-QRS Tachycardias

- Sinus Tachycardia

- Atrial Tachycardia

- AV Nodal Reentrant Tachycardia

- AV Reentrant Tachycardia

- Junctional Tachycardia

Wide-QRS Tachycardias

- Intraventricular Conduction Defects

- Accelerated Idioventricular Rhythm

- Ventricular Tachycardia

Irregular Tachycardias

- Multifocal Atrial Tachycardia

- Atrial Flutter and Atrial Fibrillation

- Polymorphic Ventricular Tachycardia

Section 3: Bradydysrhythmias: Too Slow Rhythms

Sinus Bradycardia

- What Causes It?

- What Do I Do About It?

Junctional Escape Rhythm

- What Causes It?

- What Do I Do About It?

Ventricular Escape Rhythm

- What Causes It?

- What Do I Do About It?

Atrioventricular (AV) Blocks

- First-Degree AV Block

- Second-Degree AV Blocks

- Third-Degree AV Block

Section 4: Cardiac Arrest Rhythms

Ventricular Tachycardia

Ventricular Fibrillation

Asystole (Cardiac Standstill)

Pulseless Electrical Activity

The Resuscitation Team

- Goals of the Resuscitation Team

- Configuration of the Resuscitation Team

- Code Organization - "Phase Response"

- Helping the Caregivers

Stop and Review

Stop and Review Answers

4. Electrical Therapy

Introduction

Defibrillation

- Definition and Purpose

- Energy, Voltage, and Current

- Monophasic versus Biphasic Defibrillation

- Transthoracic Impedance

- Defibrillation Ð Procedure

Automated External Defibrillators (AEDs)

- AED Features

- AED Operation

- Special Considerations

- Maintenance

Synchronized Cardioversion

- Description and Purpose

- Procedure

Defibrillation and Cardioversion

- Special Considerations

- Possible Complications

- Possible Errors

Transcutaneous Pacing

- Procedure

- Limitations

- Possible Complications

- Pacemaker Malfunction

Stop and Review

Stop and Review Answers

5. Acute Coronary Syndromes

Introduction

Pathophysiology of Acute Coronary Syndromes

- Plaque Rupture

- Thrombus Development

- Coronary Artery Obstruction

- Other Causes of Acute Coronary Syndromes

Forms of Acute Coronary Syndromes

- Unstable Angina

- Myocardial Infarction

History and Clinical Presentation

- Patient History

- Typical Symptoms

- Anginal Equivalents

- Atypical Presentation

- Physical Examination

Patient Evaluation

- Electrocardiogram Findings

- Cardiac Biomarkers

- Imaging Studies

Initial Management of Acute Coronary Syndromes

- General Measures

- Analgesic and Anti-ischemic Therapy

- Antiplatelet Therapy

- Aspirin and Clopidogrel

- Glycoprotein IIb/IIIa Inhibitors

- Anticoagulant Therapy

- Percutaneous Coronary Intervention

- Fibrinolytic Therapy

- Coronary Artery Bypass Graft Surgery

Complications of Acute Myocardial Infarction

- Dysrhythmias

- Ventricular aneurysm

- Ventricular septal rupture

- Papillary muscle rupture

- Cardiac wall rupture

- Hypotension

- Ventricular Failure

- Pericarditis

- Embolic Complications

Stop and Review

Stop and Review Answers

6. Acute Stroke

Objectives

Introduction

Stroke Facts

Classification of Stroke by Anatomic Location

Ischemic and Hemorrhagic Stroke

- Ischemic Stroke

- Hemorrhagic Stroke

Stroke Chain of Survival

- Detection

- Dispatch

- Delivery

- Door

- Data

- Decision

- Drug

- Disposition

Stop and Review

Stop and Review Answers

PART II: CASE STUDIES

Case 1: Respiratory Arrest

Case 2: Pulseless Ventricular Tachycardia/Ventricular Fibrillation with an AED

Case 3: Pulseless Ventricular Tachycardia/Ventricular Fibrillation

Case 4: Asystole

Case 5: Pulseless Electrical Activity

Case 6: Acute Coronary Syndromes

Case 7: Symptomatic Bradycardia

Case 8: Unstable Tachycardia  NEW!

Case 9: Stable Tachycardia  NEW!

Case 10: Acute Ischemic Stroke  NEW!

Posttest

- Posttest Answers

Answer Appendix

Glossary