Wednesday, July 2, 2008

Day # 2 - ACLS

Today at TGH talked about running a "code blue" and the ACLS algorithms for pulseless VF/VT and asystole/PEA.

The full ACLS guidelines are available online here. This is an exhaustive document. I found the cardiac arrest and tachycardia/bradycardia documents the most helpful -- although the ligtning strike article was interesting.

Contrary to what was suggested, intracardiac epinephrine is not discussed in the guidelines and there is not an intracardiac epinephrine needle on the crash cart. Nevertheless it is an interesting concept.

This link appears modestly usefull as well -- though I have not gone through to verify the content of each flowchart.

Important take home messages:
* The first pulse you take is your own
* Every code needs a leader
* Quality CPR -> Check pulse/rhythm -> Quality CPR/Drugs/Shock -> Repeat
* Look for reversible causes (5H's, 5T's)
* Ask for opinions when considering stopping
* Document well
* Debrief with your team

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