The Advanced Cardiovascular Life Support (ACLS) protocol prioritizes high-quality chest compressions and early defibrillation for shockable rhythms.
Key Action Sequence
- Start CPR: Push hard (2–2.4 inches) and fast (100–120/min). Minimize interruptions.
- Check Rhythm:
- Shockable (VF/Pulseless VT): Defibrillate (Shock) → 2 min CPR → Check rhythm → Repeat.
- Non-Shockable (PEA/Asystole): Continue CPR immediately → Administer Epinephrine ASAP.
- Advanced Airway: Consider supraglottic airway or endotracheal intubation; capnography for monitoring.
Reversible Causes (H’s & T’s)
Always investigate these underlying triggers:
| H’s | T’s |
|---|---|
| Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/Hyperkalemia, Hypothermia. | Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary/coronary). |
Pharmacological Interventions
| Drug | Dosing / Notes |
|---|---|
| Epinephrine | 1 mg every 3–5 minutes. |
| Amiodarone | First dose 300 mg bolus, second 150 mg. |
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