Статті в журналах: "Advanced cardiac life support (ACLS) course"

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Jastremski, Michael S., and Alan W. Grogono. "Medical Student Education in Advanced Cardiac Life Support." Prehospital and Disaster Medicine 1, S1 (1985): 100–101. http://dx.doi.org/10.1017/s1049023x0004396x.

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A standardized approach to advanced cardiac life support (ACLS) improves the morbidity and mortality from cardiac arrest. Physicians should receive formal training, certification, and periodic recertification in ACLS. This paper describes the system we have developed to provide all the medical graduates of our university with training and American Heart Association (AHA) certification in ACLS.MethodThe course takes place during the third year of medical school in four afternoons during the students' medical clerkship. The students are required to take this course and are freed from all other commitments during these afternoons. Several weeks before the course, the students are given a brief introductory lecture, registered, and strongly encouraged to read the AHA manual for providers of advanced cardiac life support.

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Lee, Man Xin, Yuan Helen Zhang, and Fatimah Lateef. "Advanced Cardiac Life Support instruction in the new norm: Evaluating the hybrid versus the traditional model." Asia Pacific Scholar 7, no. 2 (April 5, 2022): 42–45. http://dx.doi.org/10.29060/taps.2022-7-2/sc2682.

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Introduction: Advanced Cardiac Life Support (ACLS) course is one of the mandatory certifications for the majority of medical as well as some nursing professionals. There are, however, multiple variations in its instruction model worldwide. We aim to evaluate the efficacy of traditional ACLS course versus a hybrid ACLS course utilised during the COVID-19 pandemic. Methods: This retrospective study was carried out at SingHealth Duke-NUS Institute of Medical Simulation using course results of participants in the centre’s ACLS course between May to October 2019 for the traditional course were compared with participants attending the hybrid course from February to June 2021. Results: A total of 925 participants were recruited during the study period. Of these, 626 participants were from the traditional group and 299 participants were from the hybrid learning group. There is no statistically significant difference between the two group (χ2=1.02 p = 0.313) in terms of first pass attempts; first pass attempt at MCQ (p=0.805) and first pass attempt at practical stations (p=0.408). However, there was statistically significant difference between the mean difference in results of traditional vs hybrid MCQ score, -0.29 (95% CI: -0.57 to -0.01, p=0.0409). Finally, senior doctors were also found to perform better than junior doctors in both traditional (p=0.0235) and hybrid courses (p=0.0309) at the first pass attempt of ACLS certification. Conclusion: Participants in the hybrid ACLS course demonstrated at least equal overall proficiency in certification of ACLS as compared to the traditional instruction.

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Stempien, James, and Martin Betz. "A prospective study of students’ and instructors’ opinions on Advanced Cardiac Life Support course teaching methods." CJEM 11, no. 01 (January 2009): 57–63. http://dx.doi.org/10.1017/s1481803500010927.

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ABSTRACT Introduction: The American Heart Association (AHA) revises the Advanced Cardiac Life Support (ACLS) course approximately every 5 years, citing the scientific literature for any changes to content and management recommendations. With ACLS 2005, the AHA also revised the methods used to teach course content. The AHA cited no evidence in making these changes. The ACLS 2005 course, distributed in early 2007, makes greater use of videos to teach students. This prospective study surveyed opinions of both students and instructors in an effort to determine the level of satisfaction with this method of teaching. Methods: During 16 consecutive ACLS courses, all students and instructors were asked to complete a questionnaire. The students provided demographic information, but completed the survey anonymously. Four questions probed the participants' opinions about the effectiveness of videos in learning ACLS skills. Experienced participants were asked to compare the new teaching methods with previous courses. Opinions were compared among several subgroups based on sex, occupation and previous experience. Results: Of the 180 students who participated, 71% felt the videos were unequivocally useful for teaching ACLS skills. Fewer first-time students were unequivocally positive (59%) compared with those who had taken 2 or more previous courses (84%). A small proportion of students (13%) desired more hands-on practice time. Of the 16 instructors who participated, 31% felt that the videos were useful for teaching ACLS skills. No differences were found between doctors and nurses, or between men and women. Conclusion: The use of standardized videos in ACLS courses was felt by the majority of students and a minority of instructors to be unequivocally useful. First-time students had more doubts about the effectiveness of videos.

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George, Pradeep Paul, Chee Kheong Ooi, Edwin Leong, Krister Jarbrink, Josip Car, and Craig Lockwood. "Return on investment in blended advanced cardiac life support training compared to face-to-face training in Singapore." Proceedings of Singapore Healthcare 27, no. 4 (March 4, 2018): 234–42. http://dx.doi.org/10.1177/2010105818760045.

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Background Internet adoption during the past decade has provided opportunities for innovation in advanced cardiac life support (ACLS) training. With pressure on budgets across health care systems, there is a need for more cost-effective solutions. Recently, traditional ACLS training has evolved from passive to active learning technologies. The objective of this study is to compare the cost, cost-savings and return on investment (ROI) of blended ACLS (B-ACLS) and face-to-face ACLS (F-ACLS) in Singapore. Methods: B-ACLS and F-ACLS courses are offered in two training institutes in Singapore. Direct and indirect costs of training were obtained from one of the training providers. ROI was computed using cost-savings over total cost if B-ACLS was used instead of F-ACLS. Results: The estimated annual cost to conduct B-ACLS and F-ACLS were S$43,467 and S$72,793, respectively. Discounted total cost of training over the life of the course (five years) was S$107,960 for B-ACLS and S$280,162 for F-ACLS. Annual productivity loss cost account for 52% and 23% of the costs among the F-ACLS and B-ACLS, respectively. B-ACLS yielded a 160% return on the money invested. There would be 61% savings over the life of the course if B-ACLS were to be used instead of F-ACLS. Conclusion: The B-ACLS course provides significant cost-savings to the provider and a positive ROI. B-ACLS should be more widely adopted as the preferred mode of ACLS training. As a start, physicians looking for reaccreditation of the ACLS training should be encouraged to take B-ACLS instead of F-ACLS.

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Azevedo, Lunia Sofia Lima, Lucas Gaspar Ribeiro, André Schmidt, and Antônio Pazin Filho. "Impact of training in Advanced Cardiac Life Support (ACLS) in the professional career and work environment." Ciência & Saúde Coletiva 23, no. 3 (March 2018): 883–90. http://dx.doi.org/10.1590/1413-81232018233.13762016.

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Abstract We sought to evaluate the impact of Advanced Cardiac Life Support (ACLS) training in the professional career and work environment of physicians who took the course in a single center certified by the American Heart Association (AHA). Of the 4631 students (since 1999 to 2009), 2776 were located, 657 letters were returned, with 388 excluded from the analysis for being returned lacking addressees. The final study population was composed of 269 participants allocated in 3 groups (< 3 years, 3-5 and > 5years). Longer training was associated with older age, male gender, having undergone residency training, private office, greater earnings and longer time since graduation and a lower chance to participate in providing care for a cardiac arrest. Regarding personal change, no modification was detected according to time since taking the course. The only change in the work environment was the purchase of an automated external defibrillator (AED) by those who had taken the course more than 5 years ago. In multivariable analysis, however, the implementation of an AED was not independently associated with this group, which showed a lower chance to take a new ACLS course. ACLS courses should emphasize also how physicians could reinforce the survival chain through environmental changes.

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Tafreshi, Mohammad J., and Lindsay M. Huxtable. "Advanced Cardiac Life Support (ACLS) Certification: An Innovative Course for Pharmacy Students." American Journal of Pharmaceutical Education 68, no. 1 (September 2004): 1. http://dx.doi.org/10.5688/aj680101.

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Sosa, Mary Ellen Burke. "Should Perinatal Nurses Be Required to Complete an Advanced Cardiac Life Support (ACLS) Course?" MCN, The American Journal of Maternal/Child Nursing 23, no. 4 (July 1998): 178. http://dx.doi.org/10.1097/00005721-199807000-00002.

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O'Brien-Abel, Nancy. "Should Perinatal Nurses Be Required to Complete an Advanced Cardiac Life Support (ACLS) Course?" MCN, The American Journal of Maternal/Child Nursing 23, no. 4 (July 1998): 179. http://dx.doi.org/10.1097/00005721-199807000-00003.

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Ley, S. Jill. "Standards for Resuscitation After Cardiac Surgery." Critical Care Nurse 35, no. 2 (April 1, 2015): 30–38. http://dx.doi.org/10.4037/ccn2015652.

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Of the 250 000 patients who undergo major cardiac operations in the United States annually, 0.7% to 2.9% will experience a postoperative cardiac arrest. Although Advanced Cardiac Life Support (ACLS) is the standard approach to management of cardiac arrest in the United States, it has significant limitations in these patients. The European Resuscitation Council (ERC) has endorsed a new guideline specific to resuscitation after cardiac surgery that advises important, evidence-based deviations from ACLS and is under consideration in the United States. The ACLS and ERC recommendations for resuscitation of these patients are contrasted on the basis of the essential components of care. Key to this approach is the rapid elimination of reversible causes of arrest, followed by either defibrillation or pacing (as appropriate) before external cardiac compressions that can damage the sternotomy, cautious use of epinephrine owing to potential rebound hypertension, and prompt resternotomy (within 5 minutes) to promote optimal cerebral perfusion with internal massage, if prior interventions are unsuccessful. These techniques are relatively simple, reproducible, and easily mastered in Cardiac Surgical Unit–Advanced Life Support courses. Resuscitation of patients after heart surgery presents a unique opportunity to achieve high survival rates with key modifications to ACLS that warrant adoption in the United States.

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Seraj, Mohamed A., and Paul J. Harvey. "15 Years of Experience with Cardiopulmonary Resuscitation in the Kingdom of Saudi Arabia: A Critical Analysis." Prehospital and Disaster Medicine 14, no. 3 (September 1999): 73–78. http://dx.doi.org/10.1017/s1049023x00027564.

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AbstractThe objective of this review is to establish a framework about the educational activities of the Cardiopulmonary Resuscitation (CPR) National Committee of the Saudi Heart Association (SHA) and determine if it has had any effect on the survival rate in daily hospital work. Further, the review puts forward recommendations regarding the key to success for future implementations and improvement in the outcome of heart attacks in the Kingdom of Saudi Arabia (KSA).Cardiopulmonary resuscitation (CPR) was introduced into the Kingdom of Saudi Arabia in the 1980s. The birth of CPR in the Kingdom was conducted by the American Heart Association (AHA) provision of the first instructor course in Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) in the spring of 1984. This educational activity was initiated by the Postgraduate Center of the College of Medicine and currently is a function of the Saudi Heart Association (SHA). The National Heart Center (NHC) continually expands its activities. The number of courses organized, conducted, and reported herein totaled 459 for providers and instructors in BCLS and advanced cardiac life support. This resulted in certification of 916 and 204 instructors in basic and advanced CPR respectively. There were 80 centers established in the Kingdom over the span of 15 years. They all provide BCLS courses; only 13 provide advanced cardiac life support courses. The SHA issued a total of 84,659 certificates.

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Garrido, F. D., M. M. D. Romano, A. Schmidt, and A. Pazin-Filho. "Can course format influence the performance of students in an advanced cardiac life support (ACLS) program?" Brazilian Journal of Medical and Biological Research 44, no. 1 (January 2011): 23–28. http://dx.doi.org/10.1590/s0100-879x2010007500131.

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Chabot, K., J. Morris, R. Perron, C. Ranger, M. Paradis, P. Drolet, J. Cliche, L. Londei-Leduc, and A. Robitaille. "P017: Impact of the use of a checklist for transcutaneous cardiac pacing on competency of junior residents undergoing an advanced cardiac life support course." CJEM 21, S1 (May 2019): S69. http://dx.doi.org/10.1017/cem.2019.208.

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Introduction: Transcutaneous cardiac pacing (TCP) is recommended for the treatment of symptomatic bradycardia, a life-threatening condition. Although TCP is taught in ACLS (advanced cardiac life support) courses, it is a difficult skill to master for junior residents. The main objective of this study is to measure the impact of having access to a checklist on successful TCP implementation. Our hypothesis was that the availability of a CL would improve performance of junior residents in the management of symptomatic bradycardia by facilitating TCP. Methods: We conducted a prospective, randomized, single-site study. First-year residents entering postgraduate programs and taking a mandatory ACLS course were enrolled. Students had didactic sessions on the management of symptomatic bradycardia followed by hands-on teaching on a low-fidelity manikin (ALS® simulator, Laerdal) using a CL conceived for this project as a teaching tool. Study participants were then assessed with a simulation scenario requiring TCP. Participants were randomly assigned to groups with and without CL accessibility. Performances were graded on six critical tasks. The primary outcome was the successful use of TCP, defined as having completed all tasks. Participants then completed a post-test questionnaire. Sample size estimation was based on a previous project (Ranger et al., 2018). Accepting an alpha error of 0.05 and a power of 80%, 45 participants in each group would permit the detection of 26.5% in performance gain. Results: Of 250 residents completing the ACLS course in 2017, 85 voluntary participants were randomized to a control group (no CL available during testing, n = 42) or an experimental group (CL available during testing, n = 43). Six participants in the experimental group adequately used TCP compared to five participants in the control group (p = 0.81, chi-squared test). Out of the 43 participants who had access to the CL, only 2 (5%) used it. Reasons why the CL was infrequently used were stated as the following: 24 participants (56%) mentioned not realizing it was available, 8 (19%) considered it was of little to no utility and 5 (19%) forgot a CL existed. Conclusion: Availability of a checklist previously used during simulation teaching did not increase junior residents’ capacity to correctly apply TCP. Non-recognition of CL availability and decreased perceived need for it were the main reasons for marginal use. Our results suggest that there are many limiting factors to CL effectiveness.

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Ranger, C., M. Paradis, J. Morris, R. Perron, A. Cournoyer, P. Drolet, J. Paquet, and A. Robitaille. "P106: Does training with a modified high-fidelity manikin improve junior residents’ ability to establish transcutaneous pacing in an advanced cardiovascular life support course?" CJEM 19, S1 (May 2017): S114. http://dx.doi.org/10.1017/cem.2017.308.

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Introduction: Transcutaneous cardiac pacing (TCP), a skill taught in Advanced Cardiovascular Life Support (ACLS) courses, is recommended to treat unstable bradycardia. Training manikins currently available fail to reproduce key features of TCP and might be suboptimal to teach this procedure.The objective of this study was to measure the impact of a modified high-fidelity manikin on junior residents’ TCP competency during an ACLS course. We hypothesized that the use of this high-fidelity manikin improves junior residents’ performances. Methods: This prospective cohort study was conducted at the Université de Montréal in July 2015 and 2016. First-year residents undergoing their mandatory ACLS course were enrolled. The control group (2015) received the traditional curriculum, which includes hands-on teaching on Advanced Life Support manikins. The intervention group (2016) received a similar curriculum, but used a modified high-fidelity manikin that reproduces key features of TCP (e.g. use of multifunction pads, TCP induced patient twitching, ECG artifacts). Cohorts were tested with a simulation scenario requiring TCP. Performances were graded based on six critical tasks: turns on pacer function, applies multifunction pads, recognizes TCP is ineffective, achieves captures, verifies mechanical capture and prescribes sedation. Our primary outcome was successful use of TCP defined as having completed all tasks. Secondary outcomes were the success rates for each task. These were compared using Pearson’s chi-squared test. We anticipated that the success rate of TCP would increase from 20% to 50%. To obtain a power of more than 90%, 48 participants were needed in both cohorts. Results: A total of 50 residents were recruited in both cohorts. No resident that received the traditional curriculum was able to successfully establish TCP while 18 residents trained on the modified high-fidelity manikin succeeded (0 vs 36%, P<0.001). Furthermore, the latter were more likely to recognize when pacing was inefficient (12 vs 86%, P<0.001), obtain ventricular capture (2 vs 48%, P<0.001), and check for a pulse rate to confirm capture (0 vs 48%, P<0.001). Conclusion: Successful use of TCP is a difficult skill to master for junior residents. A modified high-fidelity manikin during ACLS training significantly improves their ability to establish effective pacing.

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Boysen-Osborn, Megan, Craig L. Anderson, Roman Navarro, Justin Yanuck, Suzanne Strom, Christopher E. McCoy, Julie Youm, Mary Frances Ypma-Wong, and Mark I. Langdorf. "Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United States." Journal of Educational Evaluation for Health Professions 13 (February 18, 2016): 11. http://dx.doi.org/10.3352/jeehp.2016.13.11.

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Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8 hours) in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14) or podcast (2015) as was testing: 50 multiple-choice questions (MCQ), 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015). Two of 3 tests (MCQ and fill-in) improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4) to 95.1% (92.8, 96.7, P=0.0001). For the fill-in test: 94.1% for LB (89.6, 97.2) to 96.6% for FC/TBL (92.4, 99.20 P=0.0001). For MC: 88% for LB (84, 92) to 90% for FC/TBL (86, 94, P=0.0002). For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%), and 2 or 3 components (8.1% vs. 3.2%, P=0.006). Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%). Conclusion: A FC/TBL format for ACLS marginally improved written test results.

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Sullivan, D. M. "Retention of Advanced Cardiac Life Support (ACLS) Skills Taught in a One-day Course Is Better than That Found after a Two-day Course." Academic Emergency Medicine 10, no. 5 (May 1, 2003): 453—b—453. http://dx.doi.org/10.1197/aemj.10.5.453-b.

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Heath, Janie, Dave Hanson, Rebecca Long, and Nancy A. Crowell. "Critical Care Providers’ Perceptions of the Use of Vasopressin in Cardiac Arrest." American Journal of Critical Care 14, no. 6 (November 1, 2005): 481–92. http://dx.doi.org/10.4037/ajcc2005.14.6.481.

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• Background Although published algorithms and guidelines list epinephrine and vasopressin as either/or choices for treatment of ventricular fibrillation and/or pulseless ventricular tachycardia, little is known about how critical care providers respond to this recommendation. • Objectives To assess the use of vasopressin as a first-line drug of choice for ventricular fibrillation and/or pulseless ventricular tachycardia and describe factors that may influence decision making for using vasopressin. • Methods A convenience sample from 4 academic medical centers in the United States was recruited to complete a 20-item survey on demographic factors such as year of last Advanced Cardiac Life Support (ACLS) provider course, specialty certification, predominant practice responsibility, and beliefs related to the use of vasopressin for cardiac arrest. Descriptive statistics, Pearson correlation analysis, and logistic regression were used to analyze the data. • Results A total of 214 critical care providers (80% registered nurses) completed the survey. Year of last ACLS course (r = −0.188, P = .006) was a significant demographic factor, and behavioral beliefs (attitude about using vasopressin) had the strongest relationship (r = 0.687, P < .001) and were the best predictor for intentions to use or recommend the use of vasopressin (beta=0.589, P<.001). • Conclusions Despite the recommendation for vasopressin as an agent equivalent to epinephrine for treatment of ventricular fibrillation and/or pulseless ventricular tachycardia, 63% of respondents used epinephrine as a first-line drug of choice. More research is needed to address the classification system for interpreting the quality of evidence that may influence practice.

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Bajwa, Ata, Udit Bhatnagar, Amit Sharma, Hani El-Halawany, and Randall C. Thompson. "Fibromuscular Dysplasia Leading to Spontaneous Coronary Artery Dissection with Sudden Cardiac Arrest." Case Reports in Cardiology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/708409.

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A 30-year-old previously healthy female, who was six-week postpartum, experienced sudden collapse and tonic-clonic seizure. Emergency medicine services arrived at the scene and the patient was found to be in ventricular fibrillation. Advanced cardiovascular life support (ACLS) was initiated with return of spontaneous circulation. Afterwards, her initial EKG showed atrial fibrillation with rapid ventricular rate, ST elevation in leads II, III, and aVF, and ST depression in V2–V4. She was transferred to a tertiary care hospital where emergent angiogram was performed revealing obstruction of blood flow in the proximal and mid right coronary artery (RCA). A hazy and irregularly contoured appearance of the RCA was consistent with diagnosis of fibromuscular dysplasia. Subsequently, intravascular ultrasonogram (IVUS) was performed which confirmed the diagnosis of RCA dissection. Successful revascularization of the RCA was performed using two bare mental stents. After a complicated course in hospital, she was discharged in stable condition and did very well overall.

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Lee, Christopher C., Mark Im, Tae Min Kim, Edward R. Stapleton, Kyuseok Kim, Gil Joon Suh, Adam J. Singer, and Mark C. Henry. "Comparison of Traditional Advanced Cardiac Life Support (ACLS) Course Instruction Vs. a Scenario-Based, Performance Oriented Team Instruction (SPOTI) Method for Korean Paramedic Students." Journal of Emergency Medicine 38, no. 1 (January 2010): 89–92. http://dx.doi.org/10.1016/j.jemermed.2007.11.078.

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Lee, C. C., M. Im, E. R. Stapleton, T. Kim, A. J. Singer, and M. C. Henry. "47: Comparison of Traditional Advanced Cardiac Life Support (ACLS) Course Instruction vs. Scenario-based, Performance–Oriented Team Instruction (SPOTI) Method to Korean Paramedic Students." Annals of Emergency Medicine 50, no. 3 (September 2007): S16. http://dx.doi.org/10.1016/j.annemergmed.2007.06.078.

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Arreola-Risa, Carlos, Charles Mock, Alejandro J. Herrera-Escamilla, Ismael Contreras, and Jorge Vargas. "Cost-Effectiveness and Benefit of Alternatives to Improve Training for Prehospital Trauma Care in Mexico." Prehospital and Disaster Medicine 19, no. 04 (December 2004): 318–25. http://dx.doi.org/10.1017/s1049023x00001953.

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AbstractIntroduction:In Latin America, there is a preponderance of prehospital trauma deaths. However, scarce resources mandate that any improvements in prehospital medical care must be cost-effective. This study sought to evaluate the costeffectiveness of several approaches to improving training for personnel in three ambulance services in Mexico.Methods:In Monterrey, training was augmented with PreHospital Trauma Life Support (PHTLS) at a cost of [US]$150 per medic trained. In San Pedro, training was augmented with Basic Trauma Life Support (BTLS), Advanced Cardiac Life Support (ACLS), and a locally designed airway management course, at a cost of $400 per medic. Process and outcome of trauma care were assessed before and after the training of these medics and at a control site.Results:The training was effective for both intervention services, with increases in basic airway maneuvers for patients in respiratory distress in Monterrey (16% before versus 39% after) and San Pedro (14% versus 64%). The role of endotrachal intubation for patients with respiratory distress increased only in San Pedro (5% versus 46%), in which the most intensive Advanced Life Support (ALS) training had been provided. However, mortality decreased only in Monterrey, where it had been the highest (8.2% before versus 4.7% after) and where the simplest and lowest cost interventions were implemented. There was no change in process or outcome in the control site.Conclusions:This study highlights the importance of assuring uniform, basic training for all prehospital providers. This is a more cost-effective approach than is higher-cost ALS training for improving prehospital trauma care in environments such as Latin America.

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Takavar, Farnaz, Mehdi Momeni, Narges Mohammadrezaie, Ahmad Ghoochani Khorasani, and Mehrad Aghili. "Comparison the impact of face-to-face training package for resuscitation with presentation by messaging software on emergency medicine rotation interns." Journal of Preventive Epidemiology 6, no. 1 (July 1, 2021): e06-e06. http://dx.doi.org/10.34172/jpe.2021.06.

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Introduction: Conventional approaches in advanced cardiac life support (ACLS) are used, including; lectures, video presentations, practical educations on moulage, also employing messenger applications can potentially be regarded as a method to train interns. Objectives: The current study aims to compare two methods of face-to-face and virtual training by WhatsApp messenger, regarding the impact of training on interns’ knowledge and satisfaction for advanced cardio resuscitation rotational interns in emergency medicine. Patients and Methods: In this cross-sectional study, 73 rotation interns of emergency medicine of Tehran University of Medical Sciences from 2017 to 2018 were divided into two groups: 1) face-to-face training, 2) virtual training by using WhatsApp messenger application. Initially, a pretest of 10 questions about main topics in advanced cardiac support was conducted on interns. At the end of training course, a posttest of 20 questions was conducted for both groups. Results: Mean value of pretest was 6.46 for face-to-face training group and 5.97 for WhatsApp group (P=0.29). Posttest mean score was 14.08 for face-to-face group and 12.03 for WhatsApp (P=0.003). Interns’ satisfaction scores were 7.68 and 7.36 for face-to-face and WhatsApp group respectively (P=0.25). Mean scores of pretest and posttest within group had no significant differences between groups, but Cohen’s effect size for face-to-face group was greater than WhatsApp trained group. Conclusion: Face-to-face training was associated with better results in promoting knowledge of interns, compared to WhatsApp training. That’s advisable to employ face-to-face training for interns.

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Ching, CK, BSH Leong, P. Nair, KC Chan, E. Seow, F. Lee, K. Heng, et al. "Singapore Advanced Cardiac Life Support Guidelines 2021." Singapore Medical Journal 62, no. 08 (August 31, 2021): 390–403. http://dx.doi.org/10.11622/smedj.2021109.

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Advanced cardiac life support (ACLS) emphasises the use of advanced airway management and ventilation, circulatory support and the appropriate use of drugs in resuscitation, as well as the identification of reversible causes of cardiac arrest. Extracorporeal cardiopulmonary resuscitation and organ donation, as well as special circumstances including drowning, pulmonary embolism and pregnancy are addressed. Resuscitation does not end with ACLS but must continue in post-resuscitation care. ACLS also covers the recognition and management of unstable pre-arrest tachy- and bradydysrhythmias that may deteriorate further.

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Stair, Thomas O. "Advanced cardiac life support (ACLS) teaching series." American Journal of Emergency Medicine 6, no. 6 (November 1988): 675. http://dx.doi.org/10.1016/0735-6757(88)90132-5.

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Rana, Shavana Rajya Laxmi, Arun Neopane, Sunita Panta, Anjan Khadka, Thaneshwar Rijal, and Nagendra Bahadur K.C. "Assessment of Knowledge on Basic Life support and Advanced Cardiac Life Support in a Medical College of Kathmandu." Medical Journal of Shree Birendra Hospital 21, no. 1 (July 7, 2022): 17–22. http://dx.doi.org/10.3126/mjsbh.v21i1.40969.

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Introduction: Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) are part of cardio-pulmonary resuscitation. The knowledge of BLS and ACLS is very important in saving lives for healthcare workers for which they need training and updated knowledge on these topics. The aim of the study was to assess the knowledge on BLS and ACLS in a medical college of Kathmandu. Methods: This was a cross sectional retrospective study conducted in Nepalese Army Institute of Health Sciences. The pretest and posttest scores of the trainees who participated in BLS and ACLS training were analyzed to assess the improvement in the knowledge. The duration of the study was from 1st May 2021 to 31st October 2021 where two sessions of the training were conducted. Data were entered in Microsoft Excel and analysis was done in Statistical Package for Social Sciences version 16. Results: Out of 72 participants, the mean pretest score was 5.67 ± 1.91 (56.67%) on BLS (Total score 10) and 9.06 ± 2.21 (60.37%) on ACLS (Total score 15). Post-test scores for BLS and ACLS were 8.69 ± 1.03 (86.94%) and 11.43 ± 1.77 (76.20%) respectively. Statistically significant increase in the mean scores were seen in both BLS [df (71) = -13.532, p < 0.001] and ACLS ([df (71) = -9.956, p < 0.001] with 95% CI while comparing pretest BLS and ACLS with posttest BLS and ACLS scores. Conclusions: Improvement in knowledge was seen amongst participants after the training. This highlights the importance of such training in imparting knowledge regarding BLS and ACLS among healthcare personnel.

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Albertson, Timothy E., Andrew Dawson, Francisco de Latorre, Robert S. Hoffman, Judd E. Hollander, Albert Jaeger, William (Russ) Kerns, Thomas G. Martin, and Mitchell P. Ross. "TOX-ACLS: Toxicologic-oriented advanced cardiac life support." Annals of Emergency Medicine 37, no. 4 (April 2001): S78—S90. http://dx.doi.org/10.1067/mem.2001.114174.

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R, Sunil, and Praseetha V.K. "Awareness of Basic Life Support & Advanced Life Support among Students in a Medical College in Kerala." Journal of Evidence Based Medicine and Healthcare 7, no. 45 (November 9, 2020): 2640–44. http://dx.doi.org/10.18410/jebmh/2020/544.

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BACKGROUND The knowledge and skills in Cardio-Pulmonary Resuscitation (CPR) is an essential part in the medical education. Resuscitation skills have undergone series of evolution into current protocol which involves Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). We wanted to assess the awareness of Basic Life Support among medical students, nursing students and house surgeons in a Government Medical College in Kerala. METHODS A cross-sectional study was conducted by assessing responses to 24 selected basic questions regarding BLS and ACLS among the students. After excluding the incomplete response forms the data from 500 responders was analysed. Results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual of AHA (2015). RESULTS Out of 500 responders, 250 were medical students, 100 were nursing students and 150 were House Surgeons. No one among them had complete knowledge of BLS & ACLS. Awareness of BLS & ACLS among students of medical, and nursing colleges and doctors is poor. Regarding knowledge of BLS (9 questions) the analysis of results showed that mean percentage of correct responses were 75.67 % of house surgeons, 51.78 % of nursing students and 20.98 % of medical students. CONCLUSIONS Awareness of BLS among students of medical, and nursing colleges and house surgeons is inadequate. Proper training programs must be initiated to rectify this. KEYWORDS BLS & ACLS Awareness, Medical Students, CPR Questionnaire

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Jeong, Hye Won, Deok Ju, Ae Kyong Lee, Jung A. Lee, Na Ru Kang, Eun Jeong Choi, Shin Hye Ahn, and Sun-Hee Moon. "Effect of a hybrid team-based advanced cardiopulmonary life support simulation program for clinical nurses." PLOS ONE 17, no. 12 (December 16, 2022): e0278512. http://dx.doi.org/10.1371/journal.pone.0278512.

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Background: During in-hospital cardiac arrest events, clinical nurses are often the first responders; therefore, nurses require sufficient advanced cardiac life support (ACLS) competency. This study aimed to verify the effects of a hybrid team-based ACLS simulation (HTAS) program (developed in this study) on nurses’ ACLS performance, specifically ACLS knowledge, cardiopulmonary resuscitation (CPR) self-efficacy, and CPR-related stress. Methods: The developed HTAS comprised four lecture videos, one team-based skills training video, and a team-based ACLS simulation. A quasi-experimental pretest-posttest design with a comparison group (CG) was used to evaluate the effectiveness of the HTAS. Of the 226 general ward nurses with more than 6 months of clinical experience, 117 were allocated to the intervention group (IG), which attended the HTAS, and 109 to the CG, which attended only basic ACLS training. Results: The IG’s ACLS performance significantly improved (t = 50.8, p < 0.001) after the training. Relative to the respective pretest conditions, posttest ACLS knowledge (t = 6.92, p < 0.001) and CPR self-efficacy (t = 6.97, p < 0.001) of the IG also significantly increased. However, when the mean difference values were compared, there was no significant difference between the two groups with respect to ACLS knowledge (t = 1.52, p = 0.130), CPR self-efficacy (t = -0.42, p = 0.673), and CPR stress (t = -0.88, p = 0.378). Conclusion: The HTAS for ward nurses was effective at enhancing the nurses’ ACLS performance. It is necessary to develop effective training methods for team-based ACLS and verify the sustained effects of such training.

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Khairunnisa, Khairunnisa, Syarifah Nora Andriaty, and Teuku Aditya Kemal. "Hubungan Pelatihan Advanced Cardiac Life Support (ACLS) dengan Tingkat Kepercayaan Diri Dokter dalam Penanganan Kasus Kegawatdaruratan Jantung di IGD Rumah Sakit." MEDIA KESEHATAN MASYARAKAT INDONESIA 20, no. 4 (July 26, 2021): 264–67. http://dx.doi.org/10.14710/mkmi.20.4.264-267.

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ABSTRAK Latar belakang: ACLS (Advanced Cardiac Life Support) adalah aktivitas sistem tanggap darurat yaitu resusitasi jantung paru (RJP) yang menggunakan pengenalan segera serangan jantung mendadak atau Sudden Cardiac Arrest (SCA) serta keterampilan untuk menyelamatkan jiwa. Kepercayaan diri merupakan suatu sikap dan keyakinan atas kemampuan diri sendiri, sehingga dapat meningkatkan rasa tanggung jawab atas perbuatan dan tindakan yang dilakukan, serta dapat mengenal kelebihan dan kekurangan diri sendiri.Metode: Penelitian ini dilakukan dengan teknik Acidental sampling, dengan sampel 71 orang yang dilakukan dalam rentang waktu 1 bulan. Metode pengumpulan data pada penelitian ini menggunakan kuesioner yang telah divalidasi. Lembaran kuesioner berisi 13 pertanyaan mengenai penerapan dan manfaat pelatihan ACLS. Responden menerima lembar informed consent sebagai lembar persetujuan mengikuti penelitian. Pengisian kuesioner menggunakan google form.Hasil: Setelah data dianalisis didapatkan hasil tingkat kepercayaan diri dokter IGD sangat percaya diri (90.1%), percaya diri (5.6%), dan tidak percaya diri (4.2%). Dokter IGD yang mengikuti pelatihan ACLS (80.3%) dan yang tidak mengikuti pelatihan ACLS (19.7%).Simpulan: Dilakukan uji chi-square didapatkan nilai (Pvalue=0.000) yang berarti terdapat hubungan pelatihan Advanced Cardiac Life Support dengan tingkat kepercayaan diri dokter dalam penanganan kasus kegawatdaruratan jantung di IGD RS. Kata kunci: ACLS, Dokter, Kegawatdaruratan Jantung ABSTRACT Background: ACLS (Advanced Cardiac Life Support) is an emergency response system activity, namely cardiac pulmonary resuscitation (CPR) which uses immediate recognition of sudden cardiac arrest or Sudden Cardiac Arrest (SCA) and life-saving skills. Self-confidence is an attitude and belief in one's own abilities, so that it can increase a sense of responsibility for the actions and actions taken, and can recognize one's own strengths and weaknesses.Method: This research was conducted by using the Acidental sampling technique, with a sample of 71 people who were conducted within a period of 1 month. The data collection method in this study used a validated questionnaire. The questionnaire sheet contains 13 questions regarding the implementation and benefits of ACLS training. Respondents received an informed consent form as a consent form to participate in the study. Filling out the questionnaire using google form.Result: After the data were analyzed, the results showed that the emergency room doctor's confidence level was very confident (90.1%), confident (5.6%), and not confident (4.2%). IGD doctors who attended ACLS training (80.3%) and who did not attend ACLS training (19.7%).Conclusion: The chi-square test was conducted to obtain a value (Pvalue = 0.000), which means that there is a relationship between advanced cardiac life support training and the level of confidence of doctors in handling cardiac emergency cases in emergency room hospitals Keywords: ACLS, Doctor, Cardiac Emergency

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Kaye, William, Arnold Sladen, and Ronald Stewart. "The Mega Code for Advanced Cardiac Life Support (ACLS): Training and Performance Evaluation." Journal of the World Association for Emergency and Disaster Medicine 3, no. 1 (1987): 77–79. http://dx.doi.org/10.1017/s1049023x00028806.

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ACLS for cardiac arrest consists of basic life support, which includes mouth-to-mouth breathing and external chest compression; management of the airway with adjunctive equipment including intubation and ventilator support with supplemental oxygen; recognition of specific cardiac dysrhythmias and appropriate emergency therapy; electrical defibrillation and cardioversion; techniques for placement of intravenous lines; diagnosis of and therapy for acidbase abnormalities with particular emphasis on respiratory and metabolic acidosis; drug therapy during the pre-arrest phase, the cardiac arrest itself, and the period following resuscitation; and stabilization, to prevent cardio-respiratory arrest, and during the post-resuscitation period. In 1975, the American Heart Association developed an ACLS Training Program in which cognitive knowledge is presented at lectures and practical skills are taught and tested at several performance stations.

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Pradhan, Sona, Karma Tenzin, Dorji Pelzom, Jigme L. Dorji, Passang Dorji, and Mongal Singh Gurung. "Knowledge, attitude and practice on advanced cardiac life support (ACLS) among the general duty medical officers in Bhutan." Bhutan Health Journal 5, no. 1 (May 15, 2019): 35–37. http://dx.doi.org/10.47811/bhj.77.

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Advanced cardiac life support (ACLS) is one of the important lifesaving procedures administered by emergency medical professionals. International guidelines and literature recommends periodic training of health personnel on ACLS. In Bhutan, the General Duty Medical Officers (GDMO) is often the first line doctors to attend to the critically sick including cardiac arrest patients.

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Hejjaji, Vittal, Ali O. Malik, Poghni A. Peri-Okonny, Merrill Thomas, Yuanyuan Tang, David Wooldridge, John A. Spertus, and Paul S. Chan. "Mobile App to Improve House Officers’ Adherence to Advanced Cardiac Life Support Guidelines: Quality Improvement Study." JMIR mHealth and uHealth 8, no. 5 (May 19, 2020): e15762. http://dx.doi.org/10.2196/15762.

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Background Effective and timely delivery of cardiac arrest interventions during in-hospital cardiac arrest resuscitation is associated with greater survival. Whether a mobile app that provides timely reminders of critical interventions improves adherence to Advanced Cardiovascular Life Support (ACLS) guidelines among house officers, who may lack experience in leading resuscitations, remains unknown. Objective The aim of this study was to assess the impact of a commercially available, dynamic mobile app on house officers’ adherence to ACLS guidelines. Methods As part of a quality improvement initiative, internal medicine house officers were invited to participate and randomized to lead 2 consecutive cardiac arrest simulations, one with a novel mobile app and one without a novel mobile app. All simulations included 4 cycles of cardiopulmonary resuscitation with different cardiac arrest rhythms and were video recorded. The coprimary end points were chest compression fraction and number of correct interventions in each simulation. The secondary end point was incorrect interventions, defined as interventions not indicated by the 2015 ACLS guidelines. Paired t tests compared performance with and without the mobile app. Results Among 53 house officers, 26 house officers were randomized to lead the first simulation with the mobile app, and 27 house officers were randomized to do so without the app. Use of the mobile app was associated with a higher number of correct ACLS interventions (out of 7; mean 6.2 vs 5.1; absolute difference 1.1 [95% CI 0.6 to 1.6]; P<.001) as well as fewer incorrect ACLS interventions (mean 0.3 vs 1.0; absolute difference –0.7 [95% CI –0.3 to –1.0]; P<.001). Simulations with the mobile app also had a marginally higher chest compression fraction (mean 90.9% vs 89.0%; absolute difference 1.9% [95% CI 0.6% to 3.4%]; P=.007). Conclusions This proof-of-concept study suggests that this novel mobile app may improve adherence to ACLS protocols, but its effectiveness on survival in real-world resuscitations remains unknown.

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Mody, Rohit, Debabrata Dash, and Bhavya Mody. "Hyperkalemic circulatory shock and cardiac arrest altered by therapeutic management: A case report." International Research Journal of Medicine and Medical Sciences 9, no. 3 (July 2021): 94–102. http://dx.doi.org/10.30918/irjmms.93.21.020.

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Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Severe hyperkalemia (Serum potassium concentration > 6.5 mmol/L) occurs most commonly from renal failure or the release of potassium from cells and can cause circulatory shock, cardiac arrhythmias or cardiac arrest. Current BLS (Basic Life Support) and ACLS (Advanced Cardiovascular Life Support) protocol should be used to manage cardiac arrest associated with hyperkalemia. But early consideration should be given to using the selective method of therapeutic management in addition to standard ACLS protocols that can be provided rapidly, effectively in patients with cardiovascular instability. We describe here a case of chronic kidney disease and congestive heart failure who developed circulatory shock and eventually cardiac arrest due to hyperkalemia managed with Calcium Gluconate, Sodium Bicarbonate and Insulin along with standard advanced cardiovascular life support protocol. Keywords: Potassium, hyperkalemia, acidosis, calcium, insulin, cardiac arrest.

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Mitchell, L. "Cardiac arrest during pregnancy: maternal-fetal physiology and advanced cardiac life support for the obstetric patient." Critical Care Nurse 15, no. 1 (February 1, 1995): 56–60. http://dx.doi.org/10.4037/ccn1995.15.1.56.

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Although cardiac arrest in pregnancy is rare, all members of the healthcare team who care for pregnant women should be aware of the maternal adaptations of pregnancy. Also, more women with preexisting medical conditions are attempting pregnancy. Perinatal nurses, especially those practicing in level III (high-risk) perinatal centers should be trained in dysrhythmia recognition and ACLS protocols. Rapid intervention sometimes can save two lives.

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Schneider, Thomas, Dietmar Mauer, Philipp Diehl, Balthasar Eberle, and Wolfgang Dick. "Quality of on-site performance in prehospital advanced cardiac life support (ACLS)." Resuscitation 27, no. 3 (May 1994): 207–13. http://dx.doi.org/10.1016/0300-9572(94)90034-5.

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Gali, Bhargavi, Grace Arteaga, Glen Au, and Vitaly Herasevich. "Impact of In Situ Education on Management of Cardiac Arrest after Cardiac Surgery." Southwest Journal of Pulmonary and Critical Care 23, no. 2 (August 16, 2021): 54–61. http://dx.doi.org/10.13175/swjpcc028-21.

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Background: Advanced life support interventions have been modified for patients who have recently undergone sternotomy for cardiac surgery and have new suture lines. We aimed to determine whether the use of in-situ simulation increased adherence to the cardiac surgery unit-advanced life support algorithm (CSU-ALS) for patients with cardiac arrest after cardiac surgery (CAACS). Methods: This was a retrospective chart review of cardiac arrest management of patients who sustained CAACS before and after implementation of in-situ simulation scenarios utilizing CSU-ACLS in place of traditional advanced cardiac life support. We utilized classroom education of CSU-ACLS followed by in-situ high-fidelity simulated scenarios of patients with CAACS.. Interprofessional learners (n = 210) participated in 18 in-situ simulations of CAACS. Two groups of patients with CAACS were retrospectively compared before and after in situ training (preimplementation, n=22 vs postimplementation, n=38). Outcomes included adherence to CSU-ALS for resuscitation, delay in initiation of chest compressions, use of defibrillation and pacing before external cardiac massage, and time to initial medication. Results: Chest compressions were used less often in the postimplementation vs the preimplementation period (11/22 [29%] vs 13/38 [59%], P = 0.02). Time to initial medication administration, use of defibrillation and pacing, return to the operating room, and survival were similar between periods. Conclusion: In this pilot, adherence to a key component of the CSU-ALS algorithm—delaying initiation of chest compressions—improved

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Blahunka, Paul C. "Pediatric Advanced Life Support (PALS): The Pharmacist's Role." Journal of Pharmacy Practice 9, no. 1 (February 1996): 42–56. http://dx.doi.org/10.1177/089719009600900105.

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The provision of pharmaceutical care to the patient undergoing cardiopulmonary resuscitation (CPR) is an important evolving concept. Pediatric resuscitation and advanced cardiac life support (ACLS) presents a particularly challenging situation for the practicing pharmacist. Etiologies of pediatric arrests include pulmonary conditions such as bronchopulmonary dysplasia, respiratory distress syndrome, respiratory syncytial virus (RSV) infection, and a myriad of accidental factors. Important initial determinations on arriving at a pediatric arrest are described, such as determining the correct weight of the patient, assessing the need for vascular access and/or intubation, and establishing the "code" leader. Recent American Heart Association guidelines for the pharmacotherapy of pediatric ACLS are discussed in detail. Included are recommendations on oxygen delivery, routes of fluid and medication administration, recent changes in epinephrine dosing, and guidelines for the proper use of adjunct medications. A detailed description of a method of using adult emergency drug syringes in the pediatric arrest is provided. Proper use of this method can expedite drug dispensing in an arrest, minimize the potential for needle-stick injury, and optimize the delivery of a patient-specific dose of medication. A "mock code" program is described that includes involvement with pharmacists, nurses, medical residents, and respiratory therapists. This program provides a hands-on role-playing model of a simulated pediatric arrest and serves as a valuable teaching tool for those charged with the responsibility of patient care during an actual arrest. While the ultimate role of the pharmacist in the pediatric arrest continues to be defined, developing the competency to provide pharmaceutical care in this clinical setting can be extremely rewarding. Copyright © 1996 by W.B. Saunders Company

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Lavery, Robert F., James Doran, Bartholomew J. Tortella, and Ronald P. Cody. "A Survey of Advanced Life Support Practices in the United States." Prehospital and Disaster Medicine 7, no. 2 (June 1992): 144–50. http://dx.doi.org/10.1017/s1049023x00039388.

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AbstractStudy Objective:A national survey was conducted to determine the sponsorship of emergency medical services (EMS) projects, composition of EMS advanced life support (ALS) teams, types of medications and equipment carried, and procedures approved for use by EMS systems in the United States.Methods:A mail survey was sent to 211 training supervisors of EMS services across the United States in 1989. The survey requested demographic and service-related information, including types of EMS sponsorship, composition of ALS teams, medications and equipment carried, and procedures which personnel have been trained to use. Medications carried were correlated with advanced cardiac life support (ACLS), the American College of Emergency Physicians (ACEP) recommended drug lists, and with the sponsoring agency.Results:One-hundred seventy (70%) survey forms were returned. The major providers of ALS in the United States are fire departments (36%), followed by private providers (26%), hospitals (22%), and local governments (16%). The most common ALS team composition was two paramedics followed by one paramedic and one emergency medical technician (EMT). Most ALS services carry all of the recommended ACLS medications; a much smaller percentage carry all of the drugs recommended by ACEP. Fire department based ALS units carried the least number of medications; hospital-based ALS units carried the highest number of medications. Combined, over 80 different medications were carried by the services responding to the survey.Conclusion:The use of ACLS drugs and procedures are well-established nation-wide; less accepted are the medications recommended by ACEP. While over 80 different medications are carried by the EMS systems that responded to this survey, only a small fraction have been investigated in the prehospital setting.

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Atkinson, P., J. Bowra, J. Milne, M. Lambert, B. Jarman, V. Noble, H. Lamprecht, et al. "LO045: Sonography in Hypotension and Cardiac Arrest (SHoC) - Cardiac Arrest: A consensus on the integration of point of care ultrasound into advanced cardiac life support during cardiac arrest." CJEM 18, S1 (May 2016): S45—S46. http://dx.doi.org/10.1017/cem.2016.82.

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Introduction: Point of care ultrasound (PoCUS) provides invaluable information during resuscitation efforts in cardiac arrest by determining presence/absence of cardiac activity and identifying reversible causes such as pericardial tamponade. There is no agreed guideline on how to safely and effectively incorporate PoCUS into the advanced cardiac life support (ACLS) algorithm. We consider that a consensus-based priority checklist using a “4 F’s” approach (Fluid; Form; Function; Filling), would provide a better algorithm during ACLS. Methods: The ultrasound subcommittee of the Australasian College for Emergency Medicine (ACEM) drafted a checklist incorporating PoCUS into the ACLS algorithm. This was further developed using the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. A modified Delphi tool was developed to reach an international consensus on how to integrate ultrasound into cardiac arrest algorithms for emergency department patients. Results: Consensus was reached following 3 rounds. The agreed protocol focuses on the timing of PoCUS as well as the specific clinical questions. Core cardiac windows performed during the rhythm check pause in chest compressions are the sub-xiphoid and parasternal cardiac views. Either view should be used to detect pericardial fluid, as well as examining ventricular form (e.g. right heart strain) and function, (e.g. asystole versus organized cardiac activity). Supplementary views include lung views (for absent lung sliding in pneumothorax and for pleural fluid), and IVC views for filling. Additional ultrasound applications are for endotracheal tube confirmation, proximal leg veins for DVT, or for sources of blood loss (AAA, peritoneal/pelvic fluid). Conclusion: The authors hope that this process will lead to a consensus-based SHoC-cardiac arrest guideline on incorporating PoCUS into the ACLS algorithm.

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Lemm, Henning, Matthias Janusch, Sebastian Dietz, and Michael Buerke. "Update Wiederbelebung oder Basic Life Support (BLS) und Advanced Cardiac Life Support (ACLS) – was gibt es Neues?!" Aktuelle Kardiologie 6, no. 01 (February 24, 2017): 31–42. http://dx.doi.org/10.1055/s-0043-100222.

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Charles, Ra, F. Lateef, and V. Anantharaman. "Strengthening Links in the “Chain of Survival”: A Singapore Perspective." Hong Kong Journal of Emergency Medicine 9, no. 3 (July 2002): 121–25. http://dx.doi.org/10.1177/102490790200900301.

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Introduction The concept of the chain of survival is widely accepted. The four links viz. early access, early cardiopulmonary resuscitation (CPR), early defibrillation and early Advanced Cardiac Life Support (ACLS) are related to survival after pre-hospital cardiac arrest. Owing to the dismal survival-to-discharge figures locally, we conducted this study to identify any weaknesses in the chain, looking in particular at bystander CPR rates and times to Basic Cardiac Life Support (BCLS) and ACLS. Methods and materials A retrospective cohort study was conducted in the Emergency Department of an urban tertiary 1500-bed hospital. Over a 12-month period, all cases of non-trauma out-of-hospital cardiac arrest were evaluated. Results A total of 142 cases of non-trauma out-of-hospital cardiac arrest were identified; the majority being Chinese (103/142, 72.5%) and male (71.8%) with a mean age of 64.3±7.8 years (range 23–89 yrs). Most patients (111/142, 78.2%) did not receive any form of life support until arrival of the ambulance crew. Mean time from collapse to arrival of the ambulance crew and initiation of BCLS and defibrillation was 9.2±3.5 minutes. Mean time from collapse to arrival in the Emergency Department (and thus ACLS) was 16.8±7.1 minutes. Three patients (2.11%) survived to discharge. Conclusion There is a need to (i) facilitate layperson training in bystander CPR, and (ii) enhance paramedic training to include ACLS, in order to improve the current dismal survival outcomes from out-of-hospital cardiac arrest in Singapore.

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Dunning, Joel. "Running a cardiac surgery advanced life support course." BMJ 331, no. 7524 (November 5, 2005): s200—s201. http://dx.doi.org/10.1136/bmj.331.7524.s200.

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Lehmann, David F., Bruce K. Shively, and Antonios H. Tzamaloukas. "Asystole Associated with Lidocaine Use in a Hyperkalemic Patient during Advanced Cardiac Life Support." Journal of Intensive Care Medicine 8, no. 1 (January 1993): 47–50. http://dx.doi.org/10.1177/088506669300800104.

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A case report of fatal asystole associated with use of lidocaine in a hyperkalemic patient is presented. The patient was a 61–year-old man with a rapidly increasing serum potassium level related to acute renal failure. Ventricular tachycardia with a pulse developed twice, for which lidocaine was administered according to the American Heart Association's ACLS protocol. Both episodes were immediately followed by asystole, the second of which was terminal. Available information suggests that this phenomenon can be explained by a synergistic effect on membrane responsiveness and conduction velocity. Thus, extreme caution should be exercised in the use of lidocaine when ventricular tachycardia complicates severe hyperkalemia.

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Gologorsky, Edward, Francisco Igor B. Macedo, Enisa M. Carvalho, Angela Gologorsky, Marco Ricci, and Tomas A. Salerno. "Postoperative Cardiac Arrest after Heart Surgery: Does Extracorporeal Perfusion Support a Paradigm Change in Management?" Anesthesiology Research and Practice 2010 (2010): 1–4. http://dx.doi.org/10.1155/2010/937215.

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Early institution of extracorporeal perfusion support (ECPS) may improve survival after cardiac arrest. Two patients sustained unexpected cardiac arrest in the Intensive Care Unit (ICU) following cardiac interventions. ECPS was initiated due to failure to restore hemodynamics after prolonged (over 60 minutes) advanced cardiac life support (ACLS) protocol-guided cardiopulmonary resuscitation. Despite relatively late institution of ECPS, both patients survived with preserved neurological function. This communication focuses on the utility of ECPS in the ICU as a part of resuscitative efforts.

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Lin, Nung-Sheng, Yen-Yue Lin, Yung-Hsi Kao, Chih-Pin Chuu, Kuo-An Wu, Jenq-Shyong Chan, and Po-Jen Hsiao. "Combination of Multidisciplinary Therapies Successfully Treated Refractory Ventricular Arrhythmia in a STEMI Patient: Case Report and Literature Review." Healthcare 10, no. 3 (March 10, 2022): 507. http://dx.doi.org/10.3390/healthcare10030507.

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Ventricular fibrillation (VF) is a life-threatening cardiac arrhythmia that can lead to loss of cardiac function and sudden cardiac death. The most common cause of VF is ischemic cardiomyopathy, especially in the context of an acute coronary event. Prompt treatment with resuscitation and defibrillation can be lifesaving. Refractory VF, or pulseless ventricular tachycardia (pVT), refers to cases that do not respond to traditional advanced cardiac life-support (ACLS) measures, and it has a low survival rate. Some new life-saving interventions and novel techniques have been proposed as viable treatment options for patients presenting with refractory VF/pVT out-of-hospital cardiac arrest; these include extracorporeal membrane oxygenation (ECMO), esmolol, stellate ganglion block (SGB), and double sequential defibrillation (DSD). Recently, DSD has been discussed and used more frequently, but its survival rate is still not promising. We report a case of refractory VF caused by acute myocardial infarction that was treated with ACLS, DSD, ECMO, and cardiac catheterization in sequence, with a successful outcome.

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Bignucolo, Adam, Adam Parent, Mark Dube, John Kusnierczyk, Dominique Ansell, and Robert Ohle. "Triple-sequential defibrillation for refractory ventricular fibrillation in a 24-year-old male out of hospital cardiac arrest." CJEM 21, no. 6 (October 4, 2019): 809–11. http://dx.doi.org/10.1017/cem.2019.415.

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SUMMARYRefractory ventricular fibrillation encountered during cardiac arrest has a mortality rate of 97%.1 As per the advanced cardiac life support (ACLS) guidelines, the management algorithm of ventricular fibrillation consists of chest compressions, epinephrine, defibrillation, and anti-arrhythmics.2 There have been reports describing the use of the fast-acting selective β-blocker, esmolol, and dual-sequential defibrillation in the management of ventricular fibrillation that is refractory to standard ACLS. We present a case of a 24-year-old male who had an out-of-hospital cardiac arrest, with refractory ventricular fibrillation despite high-quality cardiopulmonary resuscitation (CPR) and ACLS management. Along with standard ACLS, triple-sequential defibrillation was used to achieve return of spontaneous circulation (ROSC) after 82 minutes of downtime. An electrocardiogram (ECG) after ROSC showed an ST-elevation myocardial infarction (MI), and the patient underwent angiography showing a 100% occlusion of his left anterior descending artery. Following management of his coronary artery disease, he was discharged from the hospital 16 days later and was neurologically intact.

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Holguín Carvajal, Juan Pablo, Rodrigo Alejandro Robalino Guerrero, Carla Marina Salgado Castillo, Luis René Buitrón Andrade, Carla Patricia Zamora Rosero, and María Fernanda Salgado Castillo. "Evaluating the retention of skills in postgraduate physician students following a theoretical-practical course in Advanced Cardiovascular Life Support." F1000Research 8 (April 12, 2019): 458. http://dx.doi.org/10.12688/f1000research.18638.1.

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Background: For every minute CPR is delayed, the probability of survival decreases by up to 10%. For this reason, guidelines recommend routine CPR training for health care providers to improve their performance and patient results. The objective of the present study was to evaluate the retention capacity of postgraduate students of Critical Areas of the Pontificia Universidad Católica del Ecuador following a theoretical-practical course in Advanced Cardiovascular Life Support (ACLS). Methods: A total of 140 students were recruited and divided into three groups according to studied subject: Emergency Medicine and Disasters, Anesthesiology, and Critical Medicine. A theoretical-practical course was carried out, and theoretical and practical skills were assessed immediately and subsequently one month after ACLS training. For statistical analysis, measures of central tendency, one-way ANOVA, T-test and ANCOVA were used. Results: Scores for the immediate theoretical exam were 58.6% immediately after the intervention vs 40% 30 days after the intervention; in the immediate practical exam this was 77% vs 35.7%, respectively. No statistically significant difference was found between the three groups for the initial practical examination; however, for the evaluation 30 days after training a significant difference was found between Anesthesiology and the other two postgraduate studies. Conclusions: Knowledge and practical skills in ACLS of postgraduate physicians of Critical Areas deteriorate 30 days after training, especially in practical skills compared with theoretical knowledge. The results of this research indicate that it is necessary to carry out update courses more frequently, in order to keep knowledge and skills at a level that guarantees adequate care to the patient to reduce potential risk of death or disability.

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Kim, Heejin, Ki Hong Kim, Ki Jeong Hong, Yunseo Ku, Sang Do Shin, and Hee Chan Kim. "Frontal EEG Changes with the Recovery of Carotid Blood Flow in a Cardiac Arrest Swine Model." Sensors 20, no. 11 (May 28, 2020): 3052. http://dx.doi.org/10.3390/s20113052.

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Monitoring cerebral circulation during cardiopulmonary resuscitation (CPR) is essential to improve patients’ prognosis and quality of life. We assessed the feasibility of non-invasive electroencephalography (EEG) parameters as predictive factors of cerebral resuscitation in a ventricular fibrillation (VF) swine model. After 1 min untreated VF, four cycles of basic life support were performed and the first defibrillation was administered. Sustained return of spontaneous circulation (ROSC) was confirmed if a palpable pulse persisted for 20 min. Otherwise, one cycle of advanced cardiovascular life support (ACLS) and defibrillation were administered immediately. Successfully defibrillated animals were continuously monitored. If sustained ROSC was not achieved, another cycle of ACLS was administered. Non-ROSC was confirmed when sustained ROSC did not occur after 10 ACLS cycles. EEG and hemodynamic parameters were measured during experiments. Data measured for approximately 3 s right before the defibrillation attempts were analyzed to investigate the relationship between the recovery of carotid blood flow (CBF) and non-invasive EEG parameters, including time- and frequency-domain parameters and entropy indices. We found that time-domain magnitude and entropy measures of EEG correlated with the change of CBF. Further studies are warranted to evaluate these EEG parameters as potential markers of cerebral circulation during CPR.

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Rubens, Arthur J., Walt Stoy, and Gina Piane. "Using Interactive Videodisc to Test Advanced Airway Management Skills." Prehospital and Disaster Medicine 10, no. 4 (December 1995): 251–58. http://dx.doi.org/10.1017/s1049023x00042126.

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AbstractPurpose:To evaluate the effectiveness of the Actronics Interactive Learning System to teach the psychomotor skills of advanced airway management compared to the traditional method of lecture/demonstration.Methods:The study was a nonrandomized, nonequivalent comparison group design of a convenience sample of 86 American Heart Association (AHA), advanced cardiac life support (ACLS) students, who obtained instruction in airway management by the interactive videodisc (IVD) learning system (n = 41), or by the traditional method of demonstration/return demonstration (n = 45). The evaluation criteria for the students were based on the number of attempts required to perform successfully endotracheal (ET) intubation and esophageal obturator airway (EOA) insertion.Results:No statistically significant differences in the performance of ET insertion between the IVD and the traditional method of instruction could be demonstrated. However, initial certifiers for ACLS learning EOA insertion by the IVD method had a treatment effect (p = 0.004) compared to ACLS students learning by the traditional method. This treatment effect was not noted with ET intubation and EOA insertion for students seeking recertification. In a post-test satisfaction questionnaire, 34 IVD students reported satisfaction with learning airway management using this instructional method, but also expressed a preference to have an ACLS instructor available.Conclusion:This study highlights the role of IVD in teaching the complex skills of advanced airway management.

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Sanoski, Cynthia A. "ACLS Guidelines 2000: Focus on What’s “New” in the Pulseless Ventricular Tachycardia/Ventricular Fibrillation Algorithm." Journal of Pharmacy Practice 15, no. 4 (August 2002): 334–43. http://dx.doi.org/10.1177/089719002129041322.

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Despite the use of conventional treatment modalities, the probability of survival for patients experiencing cardiac arrest due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) remains quite poor. Therefore, the management of cardiac arrest remains a challenge. The most recent Advanced Cardiovascular Life Support (ACLS) guidelines have adopted an evidence-based approach toward the treatment of pulseless VT/VF. A number of evidence-based changes have been made in the treatment algorithms for these life-threatening arrhythmias, including the new recommendations for using vasopressin and intravenous amiodarone. This article will provide an overview of the evidence-based approach that was used in the development of the 2000 ACLS guidelines and will summarize the key trials that were used to support the inclusion of vasopressin and intravenous amiodarone in the pulseless VT/VF treatment algorithm. Additionally, dosing and administration issues for these agents will be discussed.

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Coniglio, Carlo, Lorenzo Gamberini, Cristian Lupi, Piergiorgio Cavallo, Marco Tartaglione, Valentina Chiarini, and Giovanni Gordini. "Resuscitative Endovascular Balloon Occlusion of the Aorta for Refractory Out-of-Hospital Non-Traumatic Cardiac Arrest – A Case Report." Prehospital and Disaster Medicine 34, no. 05 (September 9, 2019): 566–68. http://dx.doi.org/10.1017/s1049023x19004795.

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AbstractResuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous transfemoral balloon technique used in select centers for resuscitation and temporary hemostasis of bleeding patients. Several animal studies demonstrated that its application in non-traumatic cardiac arrest could enhance cerebral and coronary perfusion during cardiopulmonary resuscitation (CPR); despite this, there are few reports of its application in humans. This is a case report of REBOA application during a refractory out-of-hospital cardiac arrest in a 50-year-old man where Advanced Cardiac Life Support (ACLS) alone was unable to maintain a stable return of spontaneous circulation (ROSC) and Extracorporeal Cardiac Life Support (ECLS) was not available.

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