aha acls powerpoint presentation

• My presentations

Auth with social network:

Download presentation

We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!

Presentation is loading. Please wait.

Advanced Cardiac Life Support

Published by Darrell Fowler Modified over 9 years ago

Similar presentations

Presentation on theme: "Advanced Cardiac Life Support"— Presentation transcript:

Cardiac Arrest Management/AED

New York State Protocols Update 2006 Including AHA changes.

BRADY Chris Fraser Introduction to High- Performance CPR.

Final version 1, RESUSCITATION OUTCOMES CONSORTIUM C ontinuous C hest C ompressions Trial Final version 1,

CARDIOPULMONARY RESUSCITATION

Electrical Therapies Isfahan University Of Medical Sciences

European Resuscitation Council

CARDIOPULMONA RY RESUSCITATION

Electrical Therapies Automated External Defibrillators Defibrillation

Lecture ALS Algorithm.

Resuscitation guidelines 2010 & ACLS Updates

Presence Regional EMS February 2014 BLS CE.  Review the steps to performing quality CPR.  Demonstrate techniques of quality CPR.  Using a variety of.

Bradycardia & Tachycardia

Cardiac Arrest Skills Station

Paediatric Resuscitation Guidelines 2005

Cardiopulmonary Resuscitation Shamiel Salie Paediatric Intensive Care Unit Red Cross Children’s Hospital, University of Cape Town.

Cardiopulmonary Resussitation

Resources to Complete CPR Certification. Anticipated Problems What are the basic techniques for administering CPR? What recent revisions or updates have.

Project: Ghana Emergency Medicine Collaborative Document Title: ACLS Overview: Pulseless Arrest Author(s): Rockefeller Oteng (University of Michigan),

About project

© 2024 SlidePlayer.com Inc. All rights reserved.

You are now being redirected to bestq.info....

• Upload Ppt Presentation
• Upload Pdf Presentation
• Upload Infographics
• User Presentation
• Related Presentations

Management of Intracranial Aneurysms

By: drdwayn Views: 1978

Contraception Sterilization and Abortion

By: drdwayn Views: 1187

Introduction to Behavioral Pediatrics

By: drdwayn Views: 717

Oral Cavity Tongue and Palate

By: drdwayn Views: 1512

An Overview of Radiation Therapy for Health Care Professionals

By: drdwayn Views: 1027

Emergency Delivery and Newborn Stabilization

By: JenniferDwayne Views: 1391

Ethical and Legal Issues in EMS

By: JenniferDwayne Views: 2196

Immediate Life Support

By: JenniferDwayne Views: 2566

Respiratory Distress

By: JenniferDwayne Views: 1583

Management of Patients With Ventricular Arrhythmias and Prevention of Sudden Cardiac Death

By: JenniferDwayne Views: 1499

• About : I am Dr. Dwayne Faulk
• Occupation : Medical Professional
• Specialty : Other Health Professionals
• Country : United States of America

HEALTH A TO Z

• Eye Disease
• Heart Attack
• Medications

Advanced Cardiac Life Support (ACLS)

Dec 10, 2012

440 likes | 2.35k Views

Advanced Cardiac Life Support (ACLS). By: Diana Blum MSN Metropolitan Community College Nursing 2150. STABLE.  These patients generally have an EKG rhythm that is undesirable. their vitals signs are stable they have no complaints such as, shortness of breath, chest pain or confusion.

Share Presentation

• acls secondary survey abcds
• epinephrine
• metropolitan community college nursing
• problem search

Presentation Transcript

Advanced Cardiac Life Support (ACLS) By: Diana Blum MSN Metropolitan Community College Nursing 2150

STABLE •  These patients generally have an EKG rhythm that is undesirable. • their vitals signs are stable • they have no complaints such as, shortness of breath, chest pain or confusion. • if rhythm untreated the patient may become ____________.

UNSTABLE  • These patients also have an EKG rhythm that is undesirable. • vital signs are not stable! • Other sign and symptoms: low blood pressure, shortness of breath, chest pain or confusion. • if the rhythm is not treated the patient may die.. • BE AGGRESSIVE in approach in unstable patients. • You should always do CPR until code cart is available. Rhythms Too fast; like ventricular tachycardia, or ventricular fibrillation we defibrillate. Absent, as in asystole we pace with a Trans Cutaneous Pacing patches.

DEAD • These patients also have an EKG rhythm that is undesirable. • vital signs are absent! They have no pulse! • Your first thought for intervention is SHOCK EM! Especially if witness going down. • Step 2 CPR. ---new protocol is compressions compressions compressions! • The last intervention in order is MEDICINE. • "all dead people get epinephrine, the deader they are, the more epinephrine they get!" • American Heart studies show that the sooner electrical intervention is introduced, the better the outcome for survival! • Your second intervention is CPR. Think of CPR as your bridge and time-buyer. • Good CPR keeps the vital organs per fused until your electrical and drugs can do their job. • Always make good CPR a priority.

Primary Survey • Airway: Open airway, look, listen, and feel for breathing • Breathing: If not breathing slowly give 2 rescue breaths. If breaths go in continue to next step. • Circulation: check pulse 5-10 seconds • Defibrillation: Search for a shockable rhythm like vtach/vfib

Adult ACLS Secondary Survey ABCDs (abbreviated) • Airway: Intubate if not breathing. Assess bilateral breath sounds for proper tube placement. • Breathing: Provide positive pressure ventilations with 100% O2. • Circulation: If no pulse continue CPR, obtain IV access, give proper medications. • Differential Diagnosis: Attempt to identify treatable causes for the problem.

http://www.youtube.com/watch?v=tVHJq9op5cw&feature=relmfu

Pulseless Electrical Activity, or PEA • This is a condition where you have some electrical activity but not mechanical activity. • AKA: no pulse is present. • You can have a normal sinus rhythm, but if there is no pulse, the condition is called PEA. • If you have a patient with the condition of PEA, and the rhythm is a slow wide ventricular rhythm, you may want to try TCP.

PEA • Problem search..Treat accordingly. (see differential diagnosis table) Epinephrine 1 mg IV/IO q3-5 min. Or vasopressin 40 U IV/IO, once, in place of the 1st or 2nd dose of epi. Atropine 1 mg IV/IO q3-5 min. (3mg max.)

ELECTRICAL! • If the rhythm is too fast, the goal is to slow it down and convert it • use synchronized cardioversion. • If too slow the goal is to speed it up, • use external transcutaneous pacing or TCP. • “ how do I know when to pace, defibrillate, or use synchronized cardioversion?" • HINT: D=Deceased, • only defibrillate fast rhythms! • look at suspected asystole in more that one ekg lead, to confirm asystole.

Bradycardia • HR (<60bpm) or relative (slower rate than expected) bradycardia with circulatory compromise. Start the Secondary ABCDs • Pacing:Immediately prepare for transcutaneous pacing related to bradycardia (especially high-degree blocks) or if atropine failed to increase rate. • Always Atropine1st-line drug, 0.5 mg IV/IO q3-5 min. (max. 3mg) • Ends: Epinephrine2-10 µg/min2nd-line drugs to consider if atropine and/or TCP are ineffective.. • Danger: Dopamine2-10 µg/kg/min • *pacing may not work every time with brady arrhythmias. If the above measures do not improve circulatory stability the bradycardia may be from other issues, think differential diagnosis! (Refer to slide 10)

Cardioversion • Synchronized Electrical Cardioversion • the following mnemonic directs preparations for synchronized electrical cardioversion of unstable tachycardia with fast rate (do not delay shocking if seriously unstable) • Oh O2 Saturation monitor • Say Suctioning equipment • It IV line • Isn't Intubation equipment • So Sedation and possibly analgesics **Synchronized Electrical Cardioversion *Energy Levels:The initial synchronized shock is 100J monophasic (50J for SVT/A-Flutter) with increasing energy, i.e., 200J, 300J, 360J, if successive shocks are needed.

Adult Cardiac Arrest

1st Start CPR • Is the rhythm shockable? Yes or No • If shockable (VF/VT)? Yes or NO • If not shockable(Asystole)? Yes or NO • If VF/VT • Shock • CPR x 2 minutes • Get IV/IO access • Reanalyze (shockable??) • Yes • Shock then CPR x 2minutes and or epinephrine/capnography • NO • CPRx 2 minutes, epinephrine/ Airway • Repeat steps as needed • Asystole • CPR x 2 minutes, , epinephrine/ Airway • Reanalyze • Shockable • Yes • Shock cpr epinephrine airway • No • CPR x 2 minutes, treat causes

Mega code practice • http://www.acls.net/quiz.htm • http://www.mdchoice.com/cyberpt/acls/acls.asp

• More by User

advanced cardiac life support acls

1.63k views • 17 slides

Advanced Life Support in perspective

Advanced Life Support in perspective. Chain of survival: 1. Early access to emergency services [911]. 2. Early Basic life Support [by hands only]. 3. Early defibrillation . 4. Early Advanced Life Support. Causes &amp; prevention of Cardio respiratory arrest.

700 views • 34 slides

Pediatric Advanced Life Support

Pediatric Advanced Life Support. Jan Bazner-Chandler CPNP, CNS, MSN, RN. American Heart Association. Pediatric Advanced Life Support Guidelines first published in 1997 Revisions made in 2005. Students Nurse Concerns.

1.25k views • 52 slides

Basic Life Support and ACLS

Basic Life Support and ACLS. Esther Tsang Nov 2011. Case 1. 70 year old man admitted for sepsis for the past one week. Treated with antibiotics but remains very ill. Course of illness complicated by acute renal failure. Was fairly stable during the morning.

808 views • 11 slides

Advanced Cardiac Life Support

2. Advanced Life Support in perspective. Chain of survival: 1. Early access to emergency services [911]. 2. Early Basic life Support [by hands only]. 3. Early defibrillation . 4. Early Advanced Life Support.. 3. Causes

1.39k views • 44 slides

Pediatric Advanced Life Support. Guidelines established in 1983 by the American heart Association. Pediatric Advanced Life Support: A Review of the AHA Recommendations, American Family Physician, October 15, 1999. Http://www.aafp.org/afp/991015ap/1743.html. Cardiopulmonary Arrest.

1.03k views • 23 slides

Advanced Cardiac Life Support 2004

Advanced Cardiac Life Support 2004. Mark I. Langdorf, MD, MHPE, FACEP Professor or Clinical Emergency Medicine Chair and Associate Residency Director University of California, Irvine. ACLS History. Sixth iteration of guidelines since 1966 Second that is evidence based

712 views • 36 slides

Advanced Cardiac Life Support Instructor Course

Why Teach Advanced Cardiac Life Support?. . Purpose:. To create an environment conducive to the learning of the Advanced Cardiac Life Support provider material.To provide encouragement to the students and fellow instructors.To maintain and improve the instructor's skills both in communication and

2.47k views • 198 slides

Cardiac Arrest 2014 Beyond ACLS

Cardiac Arrest 2014 Beyond ACLS. Jason Mansour, MD, FACEP Broward General Medical Center Emergency Medicine. Objectives . Definition Epidemiology Pathophysiology ACLS: past, present, and future Cardiocerebral Resuscitation Reversible causes (5H’s, 5T’s) Post-resuscitation care

1.31k views • 69 slides

Pediatric Advanced Life Support. Jan Bazner-Chandler CPNP, CNS, MSN, RN. American Heart Association. Pediatric Advanced Life Support Guidelines first published in 1997 Revisions made in 2005 Revisions made in 2010. Students Nurse Concerns.

1.32k views • 65 slides

Cardiac Life Support

Dr.Dhananjaya Bulathwatta. Cardiac Life Support. BLS. ALS. BLS. Defined as “the preservation or restoration of life by the establishment and/or the maintenance of airway, breathing and circulation, and related emergency care. Importance. Importance. CPR TIME LINE

666 views • 26 slides

Cardiac Review

Cardiac Review. Cardiac Monitoring, Leads, Identifying Ischemia, Infarction &amp; Location, ACLS Algorithms, Other Cardiac Problems. Cardiac Monitoring – Lead I. Lead II. Lead III. MCL1. How it looks on a real chest. 12 Lead Electrode Placement.

797 views • 62 slides

Presenting Advanced Cardiac Life Support (ACLS) to nurses using Emotional Intelligence

Presenting Advanced Cardiac Life Support (ACLS) to nurses using Emotional Intelligence. Theodore A. Pettinicchi, MSN, RN-BC Walden University. Objectives. Participants will be able to describe emotional intelligence

503 views • 24 slides

Knowledge Nugget Become an ACL Wizard – Advanced ACL Editing

Knowledge Nugget Become an ACL Wizard – Advanced ACL Editing. Bogdan Doinea - [email protected] Assoc. Technical Manager CEE, Russia&amp;CIS Cisco Networking Academy. Basic types of ACLs The power of Named ACLs Tips and Tricks The trick to editing Numbered ACLs Technical DEMO.

269 views • 9 slides

ADVANCED CARDIAC LIFE SUPPORT

ADVANCED CARDIAC LIFE SUPPORT. SA NODE: IRAMA SINUS AV NODE: IRAMA JUNCTIONAL SERABUT PURKINJE: IRAMA IDIOVENTRIKULAR. 90 % pasien henti jantung dengan ventrikel fibrilasi dan ventrikel takikardi tanpa nadi

2.54k views • 109 slides

Advanced Cardiac Life Support. N.Tavakoli Assistant professor Department of Emergency Medicine Iran University of Medical Sciences. Chain of Survival. Early ACCESS. Early CPR. Early DEFIB. Early ACLS. Drug Administration Route. Peripheral Venous Central Venous Endotracheal

944 views • 66 slides

Advanced Cardiac Life Support. Dr. Mohammad Taraz Tehran University of Medical Science. PRINCIPLES OF MANAGEMENT. Excellent basic life support &amp; its importance Excellent CPR &amp; early defibrillation for treatable arrhythmias remain the cornerstones of basic &amp; ACLS.

1.81k views • 39 slides

Pediatric Advanced Life Support. Make Checks available to: Life Support Education. Agenda. DAY 1 Course introductions and overview Review new 2011 updates BLS primary survey video PALS secondary survey video CPR and AED practice, ETCO2 monitoring (group 1)

2.42k views • 79 slides

Basic Cardiac Life Support Review

B. Basic Cardiac Life Support Review. Topics. Before Beginning Resuscitation Rescue Breathing CPR Clearing Airway Obstructions Applying ECG Electrodes Post–Cardiac Arrest Care. Before Beginning Resuscitation. Back to Topics. Sudden Cardiac Arrest.

1.09k views • 106 slides

Advanced Cardiac Life Support: An Algorithm to Relive

Advanced cardiac life support is abbreviated as "ACLS". It refers to a set of algorithms that are required for the urgent treatment of the patient suffering from cardiac arrest, stroke, myocardial fractional or heart attack, or any other life-threatening cardiovascular emergencies. ACLS treatment refers to a serious medical emergency. Only qualified, experienced, and skilled healthcare professionals can provide it. To become a successful healthcare professional in performing cardiovascular algorithms enroll for the ACLS courses in Ireland. For more information on ACLS courses Ireland visit: https://www.medicore.ie/emergency-care-courses/advanced-cardiac-life-support.html

238 views • 15 slides

ACLS Certification Online Course – Advanced Life Support

American Crisis Prevention & Management Association offers ACLS certification training course online. We are one of the largest providers of online healthcare certifications and recertifications on the Internet. Being operated by critical care healthcare professionals, we understand the importance of a nurse or a doctor missing a shift because of ACLS, PALS, NRP, NALS, BVP, MAB, CPI, TCI or any other certification. We make it a priority to get you initially certified or recertified as quickly and efficiently as possible! We understand the need for high-quality and accurate material. All our study materials have been written by medical professionals who have had extensive experience in critical care and have been involved in actual codes and other healthcare management situations. #acls-certification-course-advanced-life-support #aclscertificationonline #aclscertificationcoursesonline #aclsrecertification #aclsrecertificationrequirements

72 views • 4 slides

• Preferences

AHA Guidelines ACLS - PowerPoint PPT Presentation

AHA Guidelines ACLS

Aha guidelines acls – powerpoint ppt presentation.

• Know your protocols
• Know the standards (algorithms)
• Be flexible
• Your patient probably did not read the ACLS manual
• ILCOR considered over 350 literature based reviews of specific resuscitation related questions
• There were more questions than answers
• Change is bad
• Every time guidelines change, basic skills must be relearned
• Changes based on weak data may undermine the integrity of the process
• Guidelines 2000 Epinephrine Class indeterminate
• Vasopressin Class 2b
• Guidelines 2005 Epinephrine Class 2b
• Vasopressin Class indeterminate
• Change is good
• New skills save lives
• New data demands new recommendations
• Consensus may not be the right thing if there is definitive data.
• When is consensus best?
• Consensus works when it takes something everybody knows and makes it something everybody agrees to do.
• Quote from Developing Consensus in Emergency Medicine Information Technology AEM 11/04
• Reviewing ACLS is impossible without an overview of CPR
• CPR will be taught as an integral part of every ACLS course
• The goal is to use CPR to increase the efficacy of defibrillation to achieve a perfusing rhythm
• Good Data (Aufderheide, Abella and others) that we do too many ventilations.
• Universal agreement that we need to decrease ventilations.
• NO data directly comparing compression ventilation ratios
• Most wanted to see a unified pediatric/adult ratio
• All courses (BLS, ACLS, PALS) will teach CPR as part of core course
• Mega-codes will incorporate real time CPR with retesting for improper performance
• Rapid rate with full chest recoil is emphasized
• Rate of 302 compression to ventilation with BVM
• 100 compressions unsynchronized to 8-10 ventilations controlled airway
• Research indicates- 2 minutes of CPR prior to first defibrillation for a non witnessed cardiac arrest
• Prime the ATP pump
• Otherwise VFIB will go to
• Asystole or PEA
• Dont interrupt compressions
• Stopping compressions for 4 seconds
• Reduces Coronary Perfusion Pressure (CPP) to Zero.
• Studies show we stop TOO long.
• Every other intervention ( except defibrillation) in cardiac arrests should be
• Considered an adjunct to chest compressions.
• Rotation of the cardiac compressor should be every 2 minutes
• Bag-Mask ventilation is emphasized
• ..all healthcare providers should be trained in delivering effective oxygenation and ventilation with a bag and mask.
• Definitive airway may be delayed
• Rescuers may defer insertion of an advanced airway until the patient fails to respond to initial CPR and defibrillation attempts
• Stacked shocks are eliminated. Start with maximum energy setting
• There is no data to support any number of stacked shocks
• Biphasic defibs have increased conversion efficacy (gt90 in electrical phase)
• Delays in time between last compression and shock significantly change shock efficacy
• PEA or asystole are common for a brief period post shock
• Ischemic myocardium is likely to develop recurrent ventricular fibrillation
• CPR has not been shown to be detrimental even in the patient with a pulse.
• Exactly that
• Look at the rhythm.
• If organized do pulse check
• If not resume CPR without pulse check
• Route of administration
• Intraosseous is now a recommended route of administration (IIa)
• Endotracheal administration ONLY if IV/IO cannot be established (still 2-2.5 times IV dose)
• Vasopressors
• Epinephrine Upgraded from class indeterminate to class 2b.
• Vasopressin Downgraded from 2b to class indeterminate
• Epinephrine is recommended in ALL pulseless arrests
• Vasopressin may replace 1st or 2nd of epinephrine. Timing does NOT change
• One large study showed no difference in survival between epinephrine and vasopressin and a trend to better ROSC with both
• Epinephrine is the established vasopressor
• Because vasopressin effects have not been shown to differ from those of epinephrine in cardiac arrest one dose of vasopressin may replace..
• CONSIDER Antiarrhythmics
• Amiodarone 300 mg IV/IO once then consider additional 150 mg IV/IO once.
• Lidocaine 1-1.5 mg/kg first dose then 0.5-0.75 mg/kg maximum 3 doses or 3mg/kg
• Consider Magnesium 1-2 gm for torsades de pointes
• There is no evidence that any antiarrhythmic drug increases survival to hospital discharge.
• V FIB - PULSELESS V TACH
• Initial Intervention
• Identify absence of pulse and respirations.
• CPR for 2 minutes if unwitnessed arrest.
• Defibrillate
• Witnessed Arrest
• EKG or paddles for "Quick Look." Determine V fib or V tach.
• Defibrillate 200 J (Biphasic defibrillator) 360J (Monophasic defibrillator)
• Children 2 J/kg first shock 4 J/kg subsequent.
• Unwitnessed Arrest
• 2 minutes of CPR then defibrillate as per above
• I.V. balanced salt solution, TKO. ET Tube, 100 O2.(maintain EtCO2 of 30-40)
• V FIB - PULSELESS V TACH (cont.)
• Drug Therapy - (CPR for 2 minutes then defibrillate after each drug given).
• Initial drug (adults only)
• Vasopressin 40 units IV, single dose one time only
• After 3-5 minutes
• Epinephrine 1.0 mg IV or IO. Repeat every 3-5 minutes prn
• Children 0.01mg/kg initial and subsequent doses
• If V-Fib persists, administer antiarrhythmic (If ET CO2 gt 10)
• Amiodarone 300 mg IV/IO bolus, repeat 150 mg IV bolus in 3-5 minutes prn. Children 5 mg/kg IV/IO bolus
• If Amiodarone contraindicated Lidocaine 1.5 mg/kg IV/IO bolus, repeat 0.75 mg/kg bolus in 3-5 minutes prn max 3 mg/kg. Children 1 mg/kg
• If multifocal WCT (Torsades) or Magnesium deficiency suspected
• Magnesium Sulfate 2 gm bolus I.V. (dilute in 50cc D5W wide open) Children 25-50 mg/kg
• Continuously monitor effectiveness of CPR and oxygenation. May repeat defibrillation current, as appropriate, after each 2 min of CPR (5 cycles).
• Supraventricular rhythm greater than 60/minute with pulses
• Utilize an infusion rate of the drug associated with restoration of a stable rhythm. If no antiarrhythmic given treat symptomatically.(Reduce maintenance dose only if impaired liver or heart chf, etc )
• Bradycardia
• Atropine 0.5 mg I.V. repeat as needed every 2-3 minutes (3mg total).
• Epinephrine per protocol
• Dopamine drip per protocol
• The recommended dose of atropine for cardiac arrest is 1 mg IV/IO. Maximum 3 mg. (Class indeterminate)
• No pacing in asystole
• Several randomized controlled trials failed to show benefit from attempted pacing for asystole. At this time use of pacing for patients in asystolic cardiac arrest is not recommended.
• CPR for 2 mins
• Apply EKG Leads. Determine asystole in two leads.
• I.V. TKO with balanced salt solution
• ET tube, 100 O2.
• Electrical Therapy
• Consider immediate transcutaneous pacemaker if
• Perfusing Bradycardia converting to asystole during resuscitation
• Asystole due to Adenocard administration
• Drug Therapy
• Epinephrine 1.0 mg I.V. or IO. Repeat every 3-5 minutes prn Children 0.01mg/kg initial and subsequent doses
• Atropine 1mg I.V. or IO q 3-5 minutes to max 3mg. Child 0.02 mg/kg.
• If rhythm is restored, follow appropriate protocols e.g., fibrillation, bradycardia, hypotension, etc. If asystole persists, consider termination of efforts.
• Pulseless Electrical Activity
• CPR for 2 mins.
• EKG paddles or leads. Determine presence of PEA (electrical rhythm without pulses).
• Continue CPR for 2 mins
• I.V. volume challenge with 300-500 cc. balanced salt solution
• ET tube, 100 O2
• Pulseless Electrical Activity (cont.)
• If bradycardia, Atropine 1 mg I.V., may repeat q 3-5 minutes to max 3mg.
• If witnessed event, consider Transcutaneous Pacemaker
• Continuously monitor effectiveness of CPR and oxygenation
• Use of vasopressor
• Use of amiodarone vs. lidocaine vs. magnesium
• Consider Atropine 1 mg for Slow PEA or Asystole
• When youre tired?
• After 20 minutes?
• Dopamine dosing
• Guidelines 2000 Dopamine 5-20 µg/kg/min
• Guidelines 2005 Dopamine 2-10 µg/kg/min
• NO explanation in text. Why
• Consultation with editors/authors
• For simplification we decided to have a single dose for dopamine and epinephrine ?????
• (µg/kg/min vs. µg/min)
• BUT does it make sense
• Does the change make sense
• No new data. The choice is editorial
• Pro Simpler
• Con Change for the sake of change
• Consensus strikes again
• The skilled provider can start at the appropriate dose
• Is amiodarone the ONLY drug for WCT?
• Procainamide, sotolol, ibutilide, lidocaine and magnesium are discussed in the text.
• The intent is to provide a BASIC framework to manage the majority of situations
• In the complex patient, the intent is to allow experts to tailor the treatment to the patient and situation.
• A patient on amiodarone with VT due to thyrotoxicosis induced by amiodarone should not receive more amiodarone
• Tachydysrhythmias
• Ventricular Tachycardia - (stable) with adequate perfusion.
• O2 High flow.
• 12 Lead prn (prior to and after treatment/conversion))
• Amiodarone 150 mg over 10 minutes Repeat 150 mg after 10 minutes if VT recurs
• IF VT persists, cardiovert as in unstable VT.
• If VT refractory, or Torsade or TCA OD, Magnesium Sulfate 2 grams I.V. slow (5-20 min. dilute in 50-100 cc D5W).
• Tachydysrhythmias (cont.)
• Ventricular Tachycardia - (unstable- hypotension, CHF, chest pain, SOB)
• O2 high flow.
• Versed 2.5-5 mg I.V. as needed.
• Synch cardiovert 100, 200, 300, 360j monophasic, OR 100, 150, 200, 200 j biphasic) Peds 0.5 j/kg, 1 j/kg prn
• If recurrent VT or persistent
• Amiodarone, per protocol above
• Magnesium Sulfate, per protocol above
• Wide-Complex Tachycardia (WCT) of uncertain type (SVT vs. VT)
• O2 high flow
• Amiodarone 150 mg bolus over 10 minutes repeat q 10 mins prn
• If WCT rhythm persists, cardiovert as needed as if unstable.
• UNSTABLE (see definition above)
• Cardiovert as per unstable V.T.
• Supraventricular (Narrow Complex) Tachycardia
• ATRIAL FIB/FLUTTER NO HYPOTENSION w/ rapid ventricular rate
• I.V 12 Lead as in above stable rhythms
• Diltiazem 0.25 mg/kg (maximum 20 mg) given slow over 2 mins. Avoid in patients taking B-blockers
• After 15 mins. may repeat at 0.35 mg/kg (maximum 25 mg)
• If conversion, 10mg/hr drip
• If hypotension after administration, fluids as appropriate and Calcium 250 mg
• ATRIAL FIBRILLATION/FLUTTER - unstable with rapid ventricular rate
• Cardiovert synchronized at 100,200,300,360 J. monophasic 100, 150, 200, 200j biphasic
• Peds 0.5 j/kg, 1 j/kg prn
• (Versed sedation as needed)
• Supraventricular Tachycardia (cont.)
• PSVT, nodal tachycardia, PAT etc.
• If stable, attempt vagal maneuvers
• Cough, valsalva
• Carotid sinus massage
• Establish bilateral carotid, no bruits do right CSM, wait 1 minute do left CSM if right unsuccessful.
• If PSVT persists Adenocard
• Contraindication 2?block/3?block, allergy, KNOWN WPW.
• Caution asthma, pregnancy, and pt. on Tegretol/Dipyridamole
• Ineffective in A-fib/A-flutter
• If PSVT persists stable, i.e. NO hypotension w/ rapid ventricular rate
• Diltiazem 0.25 mg/kg (maximum 20 mg) given slow over 2 mins. Avoid in patients taking B-blockers after 15 mins. may repeat at 0.35 mg/kg (maximum 25 m
• If hypotension after administration administer fluids as appropriate and Calcium 250 mg
• If hypotensive, fluid challenge 200-300 cc balanced salt.
• Contraindication pulmonary edema
• If Unstable
• synchronized Cardioversion at 100, 200, 300, 360j monophasic 50, 100, 150, 200 biphasic
• Peds 0.5j/kg, 1j/kg prn
• Versed sedation, as needed
• Vasopressin
• Positive epy effects (augment CPP) without epy side effects
• 1 dose 40 unit to replace first or second dose of epinephrine
• Studies show most effectiveness in Asystole, PEA and VF/VT no pulse.
• Higher BP and HR post arrest if used
• Can be given ET ( not preferred)
• Handicapped by extreme difficulty in giving for emergencies
• Most Effective in cardiac arrest with heart history
• Only 2 doses in cardiac arrest (300mg, 150mg)
• Must ALWAYS be diluted
• DO NOT administer with other drugs that prolong QT
• Cannot go down the tube
• 150mg over 10 minutes every 10 minutes as needed
• Maint. Drip _at_ 1 mg/min
• Relieves bradycardia,
• Ineffective if bradycardia is from
• 1 mg for patients without pulse
• 0.5mg for patients with a pulse
• Effective in cardiac arrest with NO heart history
• Increases the electrical energy required to defibrillate by more than 50
• Used if Amiodarone is contraindicated
• Can be given by ET
• Must be diluted
• Given over 5-20 minutes in cardiac arrest
• 5- 60 minutes in Torsades with a pulse
• Life threatening ventricular arrythmias due to digitalis toxicity
• Tricyclic OD, Torsades, hypomagnesemia
• Caution in renal failure patients
• ET drugs discouraged
• IO or IV preferred
• TX Betablocker and Ca Channel Toxicity
• 6, 12, 12 mg stable patient
• 12,12,18 for stable patient on theophyllin or caffeine OD
• 3 mg for dipyridamole (persantine), tegretol, heart transplant (denervated heart)
• Monophasic versus Biphasic
• Optimize tissue perfusion, especially for the brain
• Induction of mild hypothermia (33-34 C for 12-24 hours
• During resuscitation spontaneous cooling occurs to 35 C
• Improves neurologic recovery
• Low blood pressure within 2 hours
• Associated with poor neuro outcomes

PowerShow.com is a leading presentation sharing website. It has millions of presentations already uploaded and available with 1,000s more being uploaded by its users every day. Whatever your area of interest, here you’ll be able to find and view presentations you’ll love and possibly download. And, best of all, it is completely free and easy to use.

You might even have a presentation you’d like to share with others. If so, just upload it to PowerShow.com. We’ll convert it to an HTML5 slideshow that includes all the media types you’ve already added: audio, video, music, pictures, animations and transition effects. Then you can share it with your target audience as well as PowerShow.com’s millions of monthly visitors. And, again, it’s all free.

About the Developers

PowerShow.com is brought to you by  CrystalGraphics , the award-winning developer and market-leading publisher of rich-media enhancement products for presentations. Our product offerings include millions of PowerPoint templates, diagrams, animated 3D characters and more.

Create Free Account or

• Acute Coronary Syndromes
• Anticoagulation Management
• Arrhythmias and Clinical EP
• Cardiac Surgery
• Cardio-Oncology
• Cardiovascular Care Team
• Congenital Heart Disease and Pediatric Cardiology
• COVID-19 Hub
• Diabetes and Cardiometabolic Disease
• Dyslipidemia
• Geriatric Cardiology
• Heart Failure and Cardiomyopathies
• Invasive Cardiovascular Angiography and Intervention
• Noninvasive Imaging
• Pericardial Disease
• Pulmonary Hypertension and Venous Thromboembolism
• Sports and Exercise Cardiology
• Stable Ischemic Heart Disease
• Valvular Heart Disease
• Vascular Medicine
• Clinical Updates & Discoveries
• Advocacy & Policy
• Perspectives & Analysis
• Meeting Coverage
• ACC Member Publications
• ACC Podcasts
• View All Cardiology Updates
• Earn Credit
• View the Education Catalog
• ACC Anywhere: The Cardiology Video Library
• CardioSource Plus for Institutions and Practices
• ECG Drill and Practice
• Heart Songs
• Nuclear Cardiology
• Online Courses
• Collaborative Maintenance Pathway (CMP)
• Understanding MOC
• Image and Slide Gallery
• Annual Scientific Session and Related Events
• Chapter Meetings
• Live Meetings
• Live Meetings - International
• Webinars - Live
• Webinars - OnDemand
• Certificates and Certifications
• ACC Accreditation Services
• ACC Quality Improvement for Institutions Program
• CardioSmart
• National Cardiovascular Data Registry (NCDR)
• Advocacy at the ACC
• Cardiology as a Career Path
• Cardiology Careers
• Cardiovascular Buyers Guide
• Clinical Solutions
• Clinician Well-Being Portal
• Diversity and Inclusion
• Infographics
• Innovation Program
• Mobile and Web Apps

Slide Set | 2020 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease

•  Print

Download PowerPoint File

See Also: Guideline Hub | Valvular Heart Disease

Date: December 17, 2020    

Keywords: Anticoagulants, Fibrinolytic Agents, Platelet Aggregation Inhibitors, Aortic Valve Insufficiency, Aortic Valve Stenosis, Aortic Valve, Aortic Diseases, Perioperative Period, Cardiac Catheterization, Cardiac Imaging Techniques, Magnetic Resonance Imaging, Cardiovascular Surgical Procedures, Diagnostic Techniques, Cardiovascular, Drug Therapy, Echocardiography, Endocarditis, Exercise Test, Diagnostic Imaging, Angiography, Hemodynamics, Mitral Valve Stenosis, Mitral Valve Insufficiency, Heart Murmurs, Mitral Valve, Pregnancy, Heart Valve Prosthesis, Decision Making, Heart Valve Diseases, Heart Defects, Congenital, Patient Care Team, Thromboembolism, Thrombosis, Transcatheter Aortic Valve Replacement, Heart Valve Prosthesis Implantation, Catheters, Echocardiography, Transesophageal, Tricuspid Valve

You must be logged in to save to your library.

Jacc journals on acc.org.

• JACC: Advances
• JACC: Basic to Translational Science
• JACC: CardioOncology
• JACC: Cardiovascular Imaging
• JACC: Cardiovascular Interventions
• JACC: Case Reports
• JACC: Clinical Electrophysiology
• JACC: Heart Failure
• Current Members
• Campaign for the Future
• Become a Member
• Renew Your Membership
• Member Benefits and Resources
• Member Sections
• ACC Member Directory
• ACC Innovation Program
• Our Strategic Direction
• Our History
• Our Bylaws and Code of Ethics
• Leadership and Governance
• Annual Report
• Industry Relations
• Support the ACC
• Jobs at the ACC
• Press Releases
• Social Media
• Book Our Conference Center

Clinical Topics

• Chronic Angina
• Congenital Heart Disease and     Pediatric Cardiology
• Diabetes and Cardiometabolic     Disease
• Hypertriglyceridemia
• Invasive Cardiovascular Angiography    and Intervention
• Pulmonary Hypertension and Venous     Thromboembolism

Latest in Cardiology

Education and meetings.

• Online Learning Catalog
• Products and Resources
• Annual Scientific Session

Tools and Practice Support

• Quality Improvement for Institutions
• Accreditation Services
• Practice Solutions

Heart House

• 2400 N St. NW
• Washington , DC 20037
• Contact Member Care
• Phone: 1-202-375-6000
• Toll Free: 1-800-253-4636
• Fax: 1-202-375-6842
• Media Center
• Advertising & Sponsorship Policy
• Clinical Content Disclaimer
• Editorial Board
• Privacy Policy
• Registered User Agreement
• Terms of Service
• Cookie Policy

© 2024 American College of Cardiology Foundation. All rights reserved.