ACLS Study Guide

305 Pages·2017·24.25 MB·English

by  Barbara Aehlert

ACLS
STUDY GUIDE
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ACLS
STUDY GUIDE
Barbara Aehlert, MSEd, BSPA, RN
FIFTH EDITION
3251RiverportLane
St.Louis,Missouri63043
ACLSSTUDYGUIDE,FIFTHEDITION ISBN:978-0-323-40114-2
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Notices
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theirpatients,tomakediagnoses,todeterminedosagesandthebesttreatmentforeachindividualpatient,
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PREFACE TO THE FIFTH EDITION
AsStigginshasobserved,“Manyofusgrewupinclassroomsinwhichourteachersbelievedthattheway
youmaximizelearningisbymaximizinganxiety.Assessmentwasalwaystheintimidator.Manyofour
teachersbelieved that if alittle intimidation doesn’t work, turn up theheat—tryalotof intimidation.
Thisiswhymostadultstodayfeelthatbeingevaluatedisadistinctlydangerousenterprise.Italwaysleft
us feeling vulnerable”(Stiggins,2005,p. 18*).
ItookmyfirstAdvancedCardiacLifeSupport(ACLS)classmanyyearsago.Ifeltterrifiedandlost
throughouttheentirecourse.AlthoughIhadspentweeksstudyingbeforethecoursebegan,materialnow
seemedtobewritteninaforeignlanguage.Icouldfindnoresourcesto“translate”theinformationinto
somethingthatwasusefultome.Thecourseconsistedofverylonglecturesbyinstructorswhoreadslides
andofferedlittleusefulinsight.Themostmemorablepartofthecoursewasthe“PatientManagement”
station,inwhicheachcourseparticipantwasevaluatedone-on-onebyaninstructor.(Thoseofyouwho
havebeenaroundawhileareprobablyhavingflashbacksofthosedays.)Iwillneverforgetthatexperience.
Despitemypreparation,assoonasthedoorclosedbehindmeIwasamentalwreck.Theinstructor
proceededtomethodicallystripawayanyself-confidenceImighthavehadintreatingpatientswithcar-
diacemergencies.IwasabletoanswerthequestionsaskedofmeuntilIwaspresentedwithapatientwho
hadsymptomaticbradycardia.Atropinehadnotworked(transcutaneouspacingwasnotreadilyavailable
backthen),andthenextdrugrecommendedatthattimewasisoproterenol.Iknewthat.WhatIcould
notrecallwaswhetherisoproterenolwasgiveninmcg/min(correct)ormg/min.Itooka“50/50”guess
andsaidmg/min.Becausethatwasthewrongdecision,IwastoldIhadfailedandwouldneedtoattend
another2-daycourse.
Beforedrivinghome,IsatoutsideforafewminutescontemplatingwhathadhappenedandwhatI
mighthavedonetochangetheoutcome.Thenandthere,promisedmyselfIwouldbecomeanACLS
instructorsomedayandfindawaytoteachthisinformationinamoreuser-friendlyway.Ivowedtoteach
coursesthatwereusefultopracticinghealthcareprofessionalsanddeliveredinanenvironmentinwhich
the participants looked forward to theclass—insteadof dreadingit.
Astheyearspassed,IdidbecomeanACLSinstructorandIlovedit.Attheconclusionofeachcourse,
participantsoftenwroteontheirevaluationformsthatastudyguidewouldhavebeenhelpfulinpreparing
forclass.Thosesuggestionsresultedinmywritingafewpagesofinformationthatultimatelybecamea
book—this book.
The ACLS Study Guide is a course preparation tool designed for paramedic, nursing, and medical
students, ECG monitor technicians, nurses, and other allied health personnel working in emergency
departments,criticalcareunits,postanesthesiacareunits,operatingrooms,andtelemetryunits.Thefifth
edition of this book is based on the following scientific principles, treatment recommendations, and
guidelines:
(cid:129) 2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care
(cid:129) 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care Science with Treatment Recommendations
(cid:129) Otherevidence-basedtreatmentrecommendationsorsourcescitedinthereferencessectionofrele-
vantchapters.
*Stiggins,R.J.(2005).Anintroductiontostudent-involvedassessmentforlearning(5thed.).UpperSaddleRiver,NJ:PearsonPrentice v
Hall.
vi Preface to theFifth Edition
ThisbookisdesignedforusewiththeAmericanSafetyandHealthInstitute(ASHI)ACLSCourse.
ItcanalsobeusedassupplementarymaterialbythoseparticipatinginACLScoursesofferedbyother
organizations.
Ihavemadeeveryattempttoprovideinformationconsistentwiththecurrentliterature,includingthe
latest resuscitation guidelines; however, medicine is a dynamic field. Resuscitation guidelines change,
new medications and technology are being developed, and medical research is ongoing. As a result,
besuretolearnandfollowlocalprotocolsasdefinedbyyourmedicaladvisors.Theauthorandpublisher
assumenoresponsibilityorliabilityforlossordamageresultingfromtheuseofinformationcontained
within.
I genuinely hope the content of this book is helpful to you, and I wish you success in your ACLS
courseand clinical practice.
Sincerely,
Barbara Aehlert
ACKNOWLEDGMENTS
MysincerestthankstoMelissaKinseyforherguidancethroughoutthedevelopmentofthistext.Aspe-
cial thanksto the manuscript reviewers whoprovided insightful commentsand suggestions.
Aspecialthankstotheseinstructors,whosharemyACLSteachingphilosophy:RobertAiken,CEP;
AndrewBaird,CEP;EileenBlackstone,CEP;LynnBrowne-Wagner,RN;RandyBudd,CEP;Joanna
Burgan,CEP;ThomasCole,CEP;MikeConnor,CEP;PaulHoneywell,CEP;JamesJohnson,CEP;
StephenKnox,CEP;BillLoughran,RN;TerenceMason,RN;KevinMcColm,CEP;SeanNewton,
CEP; Anthony Pino, RN; Jan Post, RN; Gary Smith, MD; Ed Tirone, CEP; and Maryalice
Witzel, RN.
vii
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REVIEWERS FOR THE FIFTH EDITION
N.K. Alexander, EMT-P J.A. Nelson, DO, MS, FACOEP, FACEP
Instructor/Chief Operating Officer State EMS Medical Director
Wilton Emergency Squad, Inc FloridaDepartment of Health
Saratoga Springs, New York Tallahassee, Florida
S.L. Pinski, MD
B. Cetanyan, RN
EasternIowa Community College Head,Section of Cardiac Pacingand
Davenport,Iowa Electrophysiology
Robertand Suzanne Tomsich Department of
F.O. Garcia, EMT-P Cardiology
Cleveland Clinic Florida
President
Weston,Florida
ProfessionalEMS Education, LLC
GrandJunction,Colorado B.R. Shade, EMT-P, EMS-I, AAS
AHA Program Instructor, Adjunct Faculty,
C. Horsfield, BA
Firefighter
Paramedic TeachingFellow Paramedic, retired Assistant Safety Director
School of Health Sciences ClevelandClinic,CuyahogaCommunityCollege,
University of Surrey Willoughby Fire Department,Cityof
Guildford, Surrey, UK Cleveland
Cleveland, Ohio
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