ACLS (main) - Revision history

Danbot: Add verified PubMed references (PMIDs 34014872, 17125434)

2026-03-22T10:49:11Z

Add verified PubMed references (PMIDs 34014872, 17125434)

← Older revision		Revision as of 10:49, 22 March 2026
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	''See [[critical care quick reference]] for drug doses and equipment size by weight.'' {{AdultPage\|PALS (Main)}}.		''See [[critical care quick reference]] for drug doses and equipment size by weight.'' {{AdultPage\|PALS (Main)}}.
	==Background==		==Background==
	*A series of clinical algorithms created by the AHA/ASA used in the treatment of cardiovascular/neurological emergencies.		*A series of clinical algorithms created by the AHA/ASA used in the treatment of cardiovascular/neurological emergencies.<ref>Craig-Brangan KJ, Day MP. AHA update: BLS, ACLS, and PALS. Nursing. 2021 Jun 1;51(6):24-30. PMID 34014872</ref>
	*Involves airway management, IV access, and ECG interpretation.		*Involves airway management, IV access, and ECG interpretation.

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	*[[Alcohol abuse]], [[burns]], CNS disease, debilitated or elderly patient, [[drowning]], [[drugs and toxins]], endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, [[trauma]]		*[[Alcohol abuse]], [[burns]], CNS disease, debilitated or elderly patient, [[drowning]], [[drugs and toxins]], endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, [[trauma]]
	\|\|		\|\|
	*If severe (temperature <30°C), limit initial shocks for [[V-Fib]] or [[pulseless V-Tach]] to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.		*If severe (temperature <30°C), limit initial shocks for [[V-Fib]] or [[pulseless V-Tach]] to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C. <ref>Dager WE, et al. Pharmacotherapy considerations in advanced cardiac life support. Pharmacotherapy. 2006 Dec;26(12):1703-29. PMID 17125434</ref>
	*If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas		*If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas
	\|-		\|-

Danbot: Danbot moved page ACLS (Main) to ACLS (main): Naming convention: first word capitalized, subsequent words lowercase

2026-03-22T02:36:52Z

Danbot moved page ACLS (Main) to ACLS (main): Naming convention: first word capitalized, subsequent words lowercase

← Older revision	Revision as of 02:36, 22 March 2026
(No difference)

Ostermayer at 17:55, 16 January 2026

2026-01-16T17:55:49Z

← Older revision		Revision as of 17:55, 16 January 2026
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	''See [[critical care quick reference]] for drug doses and equipment size by weight.'' {{~~Adult top}} [[~~PALS (Main)]].''		''See [[critical care quick reference]] for drug doses and equipment size by weight.'' {{AdultPage\|PALS (Main)}}.
	==Background==		==Background==
	*A series of clinical algorithms created by the AHA/ASA used in the treatment of cardiovascular/neurological emergencies.		*A series of clinical algorithms created by the AHA/ASA used in the treatment of cardiovascular/neurological emergencies.

Rossdonaldson1: /* Treatable Conditions */

2023-06-14T20:58:56Z

Treatable Conditions

← Older revision		Revision as of 20:58, 14 June 2023
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	*Give [[fluids]]		*Give [[fluids]]
	*Transfuse [[pRBCs]] if hemorrhage or profound anemia is present		*Transfuse [[pRBCs]] if hemorrhage or profound anemia is present
	*[[Thoracotomy]] is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min		*[[Thoracotomy]] is appropriate when patient has [[cardiac arrest]] from [[penetrating trauma]] and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min
	\|-		\|-
	\| [[Hypoxia]]\|\|		\| [[Hypoxia]]\|\|
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	\|-		\|-
	\| [[Myocardial infarction]]\|\|		\| [[Myocardial infarction]]\|\|
	*Consider in all patients with [[cardiac arrest]], especially those with a history of coronary artery disease or prearrest acute coronary syndrome		*Consider in all patients with [[cardiac arrest]], especially those with a history of [[coronary artery disease]] or prearrest [[acute coronary syndrome]]
	\|\|		\|\|
	*Consider definitive care (eg, thrombolytic therapy, cardiac catheterization or coronary artery reperfusion, circulatory assist device, emergency cardiopulmonary bypass)		*Consider definitive care (eg, thrombolytic therapy, cardiac catheterization or coronary artery reperfusion, circulatory assist device, emergency cardiopulmonary bypass)
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	\|-		\|-
	\| [[Pulmonary embolism]]\|\|		\| [[Pulmonary embolism]]\|\|
	*Hospitalized patient, recent surgical procedure, peripartum, known risk factors for venous thromboembolism, history of venous thromboembolism, or prearrest presentation consistent with diagnosis of acute pulmonary embolism		*Hospitalized patient, recent surgical procedure, peripartum, known risk factors for [[venous thromboembolism]], history of venous thromboembolism, or prearrest presentation consistent with diagnosis of acute [[pulmonary embolism]]
	\|\|		\|\|
	*Administer fluids; augment with vasopressors as necessary		*Administer [[fluids]]; augment with [[vasopressors]] as necessary
	Confirm diagnosis, if possible; consider immediate cardiopulmonary bypass to maintain patient's viability Consider definitive care (eg, thrombolytic therapy, embolectomy by interventional radiology or surgery)		*Confirm diagnosis, if possible; consider immediate cardiopulmonary bypass to maintain patient's viability
			*Consider definitive care (eg, thrombolytic therapy, embolectomy by interventional radiology or surgery)
	\|-		\|-
	\| [[Tension pneumothorax]]\|\|		\| [[Tension pneumothorax]]\|\|
	*Placement of central catheter, mechanical ventilation, pulmonary disease (including asthma, chronic obstructive pulmonary disease, and necrotizing pneumonia), thoracentesis, and trauma		*Placement of [[central catheter]], [[mechanical ventilation]], pulmonary disease (including [[asthma]], [[chronic obstructive pulmonary disease]], and necrotizing [[pneumonia]]), [[thoracentesis]], and [[trauma]]
	\|\|		\|\|
	*Needle decompression, followed by chest-tube insertion		*[[Needle decompression]], followed by [[chest-tube insertion]]
	\|}		\|}

Rossdonaldson1: /* Treatable Conditions */

2023-06-14T20:56:31Z

Treatable Conditions

← Older revision		Revision as of 20:56, 14 June 2023
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	\|-		\|-
	\| [[Poisoning]]\|\|		\| [[Poisoning]]\|\|
	*[[Alcohol abuse]], bizarre or puzzling behavioral or metabolic presentation, classic toxicologic syndrome, occupational or industrial exposure, and psychiatric disease		*[[Alcohol abuse]], bizarre or puzzling behavioral or metabolic presentation, classic [[toxicologic syndrome]], occupational or industrial exposure, and psychiatric disease
	\|\|		\|\|
	*Consult toxicologist for emergency advice on resuscitation and definitive care, including appropriate antidote		*Consult toxicologist for emergency advice on resuscitation and definitive care, including appropriate antidote
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	*[[Metabolic acidosis]], excessive administration of potassium, [[drugs and toxins]], vigorous exercise, hemolysis, renal disease, [[rhabdomyolysis]], [[tumor lysis syndrome]], and clinically significant tissue injury		*[[Metabolic acidosis]], excessive administration of potassium, [[drugs and toxins]], vigorous exercise, hemolysis, renal disease, [[rhabdomyolysis]], [[tumor lysis syndrome]], and clinically significant tissue injury
	\|\|		\|\|
	*If hyperkalemia is identified or strongly suspected, treat with all of the following: 10% calcium chloride (5-10 mL by slow intravenous push; do not use if hyperkalemia is secondary to digitalis poisoning), glucose and insulin (50 mL of 50% dextrose in water and 10 units of regular insulin intravenously), sodium bicarbonate (50 mmoL intravenously; most effective if concomitant metabolic acidosis is present), and albuterol (15-20mg nebulized or 0.5mg by intravenous infusion)		*If hyperkalemia is identified or strongly suspected, treat with all of the following: 10% [[calcium chloride]] (5-10 mL by slow intravenous push; do not use if hyperkalemia is secondary to [[digitalis poisoning]]), [[glucose]] and [[insulin]] (50 mL of 50% dextrose in water and 10 units of regular insulin intravenously), [[sodium bicarbonate]] (50 mmoL intravenously; most effective if concomitant [[metabolic acidosis]] is present), and [[albuterol]] (15-20mg nebulized or 0.5mg by intravenous infusion)
	\|-		\|-
	\| [[Hypokalemia]]\|\|		\| [[Hypokalemia]]\|\|

Rossdonaldson1: /* Treatable Conditions */

2023-06-14T20:53:08Z

Treatable Conditions

← Older revision		Revision as of 20:53, 14 June 2023
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	\|-		\|-
	\| [[Acidosis]]\|\|		\| [[Acidosis]]\|\|
	*Preexisting [[acidosis]], [[DM]],[[diarrhea]], [[drugs and toxins]], prolonged resuscitation, renal disease, [[shock]]		*Preexisting [[acidosis]], [[DM]], [[diarrhea]], [[drugs and toxins]], prolonged resuscitation, renal disease, [[shock]]
	\|\|		\|\|
	*Reassess adequacy of [[oxygenation]], and [[ventilation]]; reconfirm [[endotracheal-tube placement]]		*Reassess adequacy of [[oxygenation]], and [[ventilation]]; reconfirm [[endotracheal-tube placement]]

Rossdonaldson1: /* Treatable Conditions */

2023-06-14T20:44:12Z

Treatable Conditions

← Older revision		Revision as of 20:44, 14 June 2023
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	\|-		\|-
	\| [[Acidosis]]\|\|		\| [[Acidosis]]\|\|
	*Preexisting acidosis, DM, diarrhea, drugs and toxins, prolonged resuscitation, renal disease, shock		*Preexisting [[acidosis]], [[DM]],[[diarrhea]], [[drugs and toxins]], prolonged resuscitation, renal disease, [[shock]]
	\|\|		\|\|
	*Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement		*Reassess adequacy of [[oxygenation]], and [[ventilation]]; reconfirm [[endotracheal-tube placement]]
	*Hyperventilate		*Hyperventilate
	*Consider intravenous bicarbonate if pH <7.20 after above actions have been taken		*Consider intravenous [[bicarbonate]] if pH <7.20 after above actions have been taken
	\|-		\|-
	\| [[Cardiac tamponade]]\|\|		\| [[Cardiac tamponade]]\|\|
	*Hemorrhagic diathesis, cancer, pericarditis, trauma, after cardiac surgery or MI		*Hemorrhagic diathesis, cancer, [[pericarditis]], [[trauma]], after cardiac surgery or [[MI]]
	\|\|		\|\|
	*Give fluids; obtain bedside echocardiogram		*Give [[fluids]]; obtain [[bedside echocardiogram]]
	*Perform pericardiocentesis. Immediate surgical intervention is appropriate if pericardiocentesis is unhelpful but cardiac tamponade is known or highly suspected.		*Perform [[pericardiocentesis]]. Immediate surgical intervention is appropriate if pericardiocentesis is unhelpful but cardiac tamponade is known or highly suspected.
	\|-		\|-
	\| [[Hypothermia]]\|\|		\| [[Hypothermia]]\|\|
	*Alcohol abuse, burns, CNS disease, debilitated or elderly patient, drowning, drugs and toxins, endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, trauma		*[[Alcohol abuse]], [[burns]], CNS disease, debilitated or elderly patient, [[drowning]], [[drugs and toxins]], endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, [[trauma]]
	\|\|		\|\|
	*If severe (temperature <30°C), limit initial shocks for V-Fib or pulseless V-Tach to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.		*If severe (temperature <30°C), limit initial shocks for [[V-Fib]] or [[pulseless V-Tach]] to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.
	*If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas		*If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas
	\|-		\|-
	\| [[Hypovolemia]], [[hemorrhage]], [[anemia]]\|\|		\| [[Hypovolemia]], [[hemorrhage]], [[anemia]]\|\|
	*Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma		*Major [[burns]], [[DM]], GI losses, hemorrhage, hemorrhagic diathesis, cancer, [[pregnancy]], [[shock]], [[trauma]]
	\|\|		\|\|
	*Give fluids		*Give [[fluids]]
	*Transfuse pRBCs if hemorrhage or profound anemia is present		*Transfuse [[pRBCs]] if hemorrhage or profound anemia is present
	*Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min		*[[Thoracotomy]] is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min
	\|-		\|-
	\| [[Hypoxia]]\|\|		\| [[Hypoxia]]\|\|
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	\|-		\|-
	\| [[Hypomagnesemia]]\|\|		\| [[Hypomagnesemia]]\|\|
	*Alcohol abuse, burns, DKA, severe diarrhea, diuretics, drugs (eg, cisplatin, cyclosporine, pentamidine)		*[[Alcohol abuse]], [[burns]], [[DKA]], severe [[diarrhea]], diuretics, drugs (eg, cisplatin, cyclosporine, pentamidine)
	\|\|		\|\|
	*Give 1-2 g magnesium sulfate intravenously over 2 min		*Give 1-2 g [[magnesium sulfate]] intravenously over 2 min
	\|-		\|-
	\| [[Myocardial infarction]]\|\|		\| [[Myocardial infarction]]\|\|
	*Consider in all patients with cardiac arrest, especially those with a history of coronary artery disease or prearrest acute coronary syndrome		*Consider in all patients with [[cardiac arrest]], especially those with a history of coronary artery disease or prearrest acute coronary syndrome
	\|\|		\|\|
	*Consider definitive care (eg, thrombolytic therapy, cardiac catheterization or coronary artery reperfusion, circulatory assist device, emergency cardiopulmonary bypass)		*Consider definitive care (eg, thrombolytic therapy, cardiac catheterization or coronary artery reperfusion, circulatory assist device, emergency cardiopulmonary bypass)
	\|-		\|-
	\| [[Poisoning]]\|\|		\| [[Poisoning]]\|\|
	*Alcohol abuse, bizarre or puzzling behavioral or metabolic presentation, classic toxicologic syndrome, occupational or industrial exposure, and psychiatric disease		*[[Alcohol abuse]], bizarre or puzzling behavioral or metabolic presentation, classic toxicologic syndrome, occupational or industrial exposure, and psychiatric disease
	\|\|		\|\|
	*Consult toxicologist for emergency advice on resuscitation and definitive care, including appropriate antidote		*Consult toxicologist for emergency advice on resuscitation and definitive care, including appropriate antidote
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	\|-		\|-
	\| [[Hyperkalemia]]\|\|		\| [[Hyperkalemia]]\|\|
	*Metabolic acidosis, excessive administration of potassium, drugs and toxins, vigorous exercise, hemolysis, renal disease, rhabdomyolysis, tumor lysis syndrome, and clinically significant tissue injury		*[[Metabolic acidosis]], excessive administration of potassium, [[drugs and toxins]], vigorous exercise, hemolysis, renal disease, [[rhabdomyolysis]], [[tumor lysis syndrome]], and clinically significant tissue injury
	\|\|		\|\|
	*If hyperkalemia is identified or strongly suspected, treat with all of the following: 10% calcium chloride (5-10 mL by slow intravenous push; do not use if hyperkalemia is secondary to digitalis poisoning), glucose and insulin (50 mL of 50% dextrose in water and 10 units of regular insulin intravenously), sodium bicarbonate (50 mmoL intravenously; most effective if concomitant metabolic acidosis is present), and albuterol (15-20mg nebulized or 0.5mg by intravenous infusion)		*If hyperkalemia is identified or strongly suspected, treat with all of the following: 10% calcium chloride (5-10 mL by slow intravenous push; do not use if hyperkalemia is secondary to digitalis poisoning), glucose and insulin (50 mL of 50% dextrose in water and 10 units of regular insulin intravenously), sodium bicarbonate (50 mmoL intravenously; most effective if concomitant metabolic acidosis is present), and albuterol (15-20mg nebulized or 0.5mg by intravenous infusion)
	\|-		\|-
	\| [[Hypokalemia]]\|\|		\| [[Hypokalemia]]\|\|
	*Alcohol abuse, diabetes, use of diuretics, drugs and toxins, profound gastrointestinal losses, hypomagnesemia		*[[Alcohol abuse]], [[diabetes]], use of [[diuretics]], [[drugs and toxins]], profound gastrointestinal losses, [[hypomagnesemia]]
	\|\|		\|\|
	*If profound hypokalemia (<2-2.5 mmoL of potassium per liter) is accompanied by cardiac arrest, initiate urgent intravenous replacement (2 mmoL/min intravenously for 10-15 mmoL), then reassess		*If profound hypokalemia (<2-2.5 mmoL of potassium per liter) is accompanied by cardiac arrest, initiate urgent intravenous replacement (2 mmoL/min intravenously for 10-15 mmoL), then reassess

Rossdonaldson1: /* Treatable Conditions */

2023-06-14T20:34:39Z

Treatable Conditions

← Older revision		Revision as of 20:34, 14 June 2023
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	\|\|		\|\|
	*Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement		*Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement
	Hyperventilate Consider intravenous bicarbonate if pH <7.20 after above actions have been taken		*Hyperventilate
			*Consider intravenous bicarbonate if pH <7.20 after above actions have been taken
	\|-		\|-
	\| [[Cardiac tamponade]]\|\|		\| [[Cardiac tamponade]]\|\|
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	*Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma		*Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma
	\|\|		\|\|
	Give fluids Transfuse pRBCs if hemorrhage or profound anemia is present		*Give fluids
			*Transfuse pRBCs if hemorrhage or profound anemia is present
	*Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min		*Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min
	\|-		\|-

Rossdonaldson1: /* Treatable Conditions */

2023-06-14T20:10:15Z

Treatable Conditions

← Older revision		Revision as of 20:10, 14 June 2023
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	*If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas		*If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas
	\|-		\|-
	\| [[Hypovolemia]], [[hemorrhage]], [[~~anemi~~]]a\|\|		\| [[Hypovolemia]], [[hemorrhage]], [[anemia]]\|\|
	*Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma		*Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma
	\|\|		\|\|

Rossdonaldson1: /* See Also */

2023-05-31T21:53:45Z

← Older revision		Revision as of 21:53, 31 May 2023
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	*Needle decompression, followed by chest-tube insertion		*Needle decompression, followed by chest-tube insertion
	\|}		\|}

	~~==See Also==~~
	*[[ACLS (Main)]]

	~~[[Category:Critical Care]]~~
	~~[[Category:Cardiology]]~~
	~~[[Category:EMS]]~~

	==See Also==		==See Also==