Version control: This document is current with respect to 2015 American Heart Association® Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 2020. If you are reading this page after October 2020, please contact ACLS Training Center at firstname.lastname@example.org for an updated document.
One of the crucial components of effective ACLS training is a familiarity with the major algorithms for different patient and/or provider scenarios. As a free resource for our visitors, this page contains links to sample algorithms for the main AHA Advanced Cardiac Life Support cases. See our website terms. Compatible part number: 90-1013, 90-1010.
Cardiac Arrest Algorithm
This case presents the recommended assessment, intervention, and management options for a patient in respiratory arrest. The patient is unresponsive and unconscious. Respirations are absent or inadequate to maintain effective oxygenation and ventilation. The patient has a pulse. Even though the patient is in respiratory arrest and not in cardiac arrest, the BLS Primary Survey and the ACLS Secondary Survey are used.
Acute Coronary Syndromes Algorithm
For this case, you use the Acute Coronary Syndromes Algorithm to guide the assessment and management of patients with signs and symptoms of acute coronary syndromes. A key focus of the case is the identification and treatment of ST-segment elevation myocardial infarction (STEMI). You use a 12-lead ECG to evaluate the patient's rhythm. You initiate treatment based on your assessment.
Your task for this case is to assess and manage a patient in cardiac arrest who has pulseless electrical activity (PEA). Although the ECG shows organized cardiac electrical activity, the patient is unresponsive with no palpable pulse. Because finding and identifying an underlying cause is critical to patient outcome, the team searches for possible causes for PEA as they administer CPR. With asystole, you search with other members of the emergency care team for a treatable cause while performing high quality CPR with minimal interruptions. IV/IO placement is a priority over advanced airway management. The team discusses when to terminate resuscitation efforts and focus on supporting the patient's family.
VF/Pulseless VT Algorithm
This case presents how to respond to someone who collapses outside of the hospital setting from either ventricular fibrillation (VF) or ventricular tachycardia (VT). You are alone and must manage the patient by yourself. You do not have the option of ACLS interventions, including advanced airway control and IV medications. You have an automated external defibrillator (AED) with a pocket face mask. The second AED case focuses on the assessment and management of a patient in a witnessed cardiac arrest caused by ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). The patient did not respond to the first shock. A manual defibrillator is used in this case, and you work with a care team.
This case outlines how to assess and manage a patient with symptomatic bradycardia. The patient has a pulse. One of your tasks is to figure out if the patient's signs and symptoms are caused by the slow heart rate or have an unrelated cause. Another task is to correctly diagnose the presence and type of atrioventricular (AV) block and implement the correct management strategies for AV blocks. You also need to know the techniques and cautions for using transcutaneous pacing.
This case presents the assessment and management of a stable patient with a pulse who has a heart rate greater than 100 bpm. Your tasks are to classify the tachycardia as narrow or wide, regular or irregular, and to implement the appropriate interventions from the ACLS Tachycardia Algorithm, including vagal maneuvers and adenosine. Monitor the patient's rhythm and request a cardiac consultation if the patient's rhythm does not convert. If the patient becomes unstable, follow the algorithm for unstable tachycardia. For unstable tachycardia, you evaluate the patient for cardioversion and perform the procedure. Drugs are not used to manage unstable tachycardia.
Suspected Stroke Algorithm
This case presents the identification (Cincinnati Prehospital Stroke Scale) and initial management of patients with acute ischemic stroke, a sudden change in neurological function brought on by a change in blood flow to the brain. This case is in scope for ACLS providers and covers fundamental out-of-hospital care, as well as basic aspects of initial in-hospital acute stroke care. This includes out-of-hospital and in-hospital situations, and National Institute of Neurological Disorders and Stroke (NINDS) time goals.
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Anesthesia ACLS Algorithms
These algorithms involve ACLS events in in-hospital settings for anesthetic and surgically related pathophysiology. Thank you to Vivek K. Moitra, MD, Andrea Gabrielli, MD, Gerald A. Maccioli, MD, and Michael F. O’Connor for providing this to us. Printed with permission.
Vivek K. Moitra, MD, Andrea Gabrielli, MD, Gerald A. Maccioli, MD, and Michael F. O’Connor, MD. Can J Anaesth. 2012 June; 59(6): 586–603.
Version control: This section for anesthesia algorithms was published in 2012. Newer guidelines have been released in the 2015 American Heart Association® Guidelines for CPR and ECC (see above). This information is provided below for historical reference and for your consideration. We will publish updated anesthesia algorithms here when and if they are published by the authors cited above. Also, please note that A. Gabrielli is also an author to updated 2015 American Heart Association® Guidelines for CPR and ECC.
This reference document summarizes the drugs used for ACLS cases and their storage requirements. Last updated 2015-05-07
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