Category: ACLS Algorithms

ACLS Algorithms Overview

ACLS (Advanced Cardiac Life Support) algorithms are a helpful reminder of what to do when presented with a patient who is exhibiting certain symptoms and certain arrhythmias. These algorithms will help the healthcare professional assess, manage, and treat patients who are either in a cardiovascular emergency or are on the path to one.

The important thing to remember is that each ACLS algorithm is associated with a particular arrhythmia. Once healthcare professionals can identify the patient’s arrhythmia, the algorithms will provide treatment steps.

The type of arrhythmia not only determines the appropriate algorithm, but the severity of the patient’s condition will determine the appropriate path within each algorithm. Stable patients will receive one course of treatment, while unstable patients will receive another.

The algorithms covered here include the following:

• Asystole Algorithm
• Pulseless Electrical Activity (PEA) Algorithm
• Tachycardia Algorithm
• Bradycardia Algorithm
• Stroke Algorithm
• Megacode Algorithm
• Respiratory Arrest Algorithm
• Acute Coronary Syndrome (ACS) Algorithm
• Pulseless Arrest Algorithm
• Adult CPR Algorithm
• Suspected Opioid Overdose Algorithm

Asystole Algorithm

The term asystole simply refers to an absence of ventricular activity, which means the patient will exhibit no discernible electrical activity on an ECG readout. This can be seen as a flat line on the monitor. In most cases, asystole is a lethal arrhythmia and survival is extremely rare.

Pulseless Electrical Activity (PEA) Algorithm

Pulseless electrical activity, most commonly known as PEA, is a condition where the electrical activity of the heart is not accompanied by a palpable or effective pulse. PEA is an organized rhythm where the electrical activity of the heart may appear normal, but the heart muscle is not responding.

Tachycardia Algorithm

In adults, tachycardia is technically defined as a heart rate greater than 100 beats per minute. Tachycardias can be both stable and unstable. Many things can cause tachycardia—fever, shock, medications, stress, metabolic dysfunction, and hypoxemia, just to name a few.

Bradycardia Algorithm

Absolute bradycardia is defined as a pulse rate less than 60 beats per minute. During the patient assessment, it’s important to determine whether any life-threatening signs and symptoms are present that have been caused by that bradycardia. Bradycardia can present itself in several different cardiac rhythms, which include sinus bradycardia and varying degrees of AV heart blocks.

Stroke Algorithm

The word stroke is a general term that refers to an acute neurological impairment following an interruption in blood supply to a specific area of tissue within the brain. The two major types of stroke are ischemic stroke (the most common type) and hemorrhagic stroke.

Megacode Algorithm

During a megacode scenario, ACLS providers must know the appropriate therapies, drugs, and dosages used in the ACLS algorithms and when to use each drug based on the situation. One must also be able to identify and interpret basic arrest and pre-arrest cardiac rhythms. Megacode scenarios combine knowledge and protocols of multiple ACLS algorithms, which can include any of the following:

• Acute coronary syndrome
• Acute stroke
• Cardiac arrest
• Pulseless VFib or V-tach
• Asystole
• Pulseless electrical activity (PEA)
• Bradycardia
• Tachycardia, whether stable or unstable

Respiratory Arrest Algorithm

Respiratory arrest cases occur when a patient has a pulse but is not breathing normally. It’s important to remember that agonal aspirations are not considered normal breathing. For a patient to be breathing normally, you must be able to see the patient’s chest rise and fall; without this sign, you should assume that sufficient air is not getting to the patient’s brain and other vital organs and that these will begin to stop working if oxygen circulation doesn’t resume promptly.

Acute Coronary Syndrome (ACS) Algorithm

Acute coronary syndrome, or ACS, is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart. One such condition is a heart attack (myocardial infarction), which occurs when cell death results in damaged or destroyed heart tissue.

Pulseless Arrest Algorithm

Ventricular fibrillation, also known as VFib, and pulseless ventricular tachycardia, also known as V-tach, are lethal dysrhythmias that do not produce a pulse. VFib is the most common initial dysrhythmia in cardiac arrest patients and will regress to asystole if it isn’t treated in a short amount of time. That treatment includes rapid defibrillation. Rapid is the key term here as every single minute that defibrillation is delayed, the chance of the patient surviving is reduced by a full 10 percent.

Adult CPR Algorithm

A patient who is unconscious, not breathing normally, and has no pulse is in cardiac arrest and needs CPR. CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped.

Suspected Opioid Overdose Algorithm

Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate.