Advanced Cardiac Life Support Explained

A stopped heart or an undetected heartbeat is not always the worst news. Thanks to massive advancements in the field of medical sciences, now, there are many systems in place that ensure that every possible step is taken to save lives. One of the most useful is advanced cardiac life support or ACLS.

ACLS is the group of medical interventions that are put in place in the event of critical emergencies, especially stroke and cardiac arrest.

In the case of a cardiac arrest, CPR often holds the answer. Cardiopulmonary resuscitation has seen many changes in the last 200 years. In fact, the earliest chest compression on a person dates back to 1891. Even prior to that, mouth-to-mouth ventilation has been suggested as a method in 1740, by The Paris Academy of Science. In 1966, the American Heart Association had adopted standardized guidelines for CPR, a mere three years after a formal endorsement of the process.

Cardiac life support can be of many kinds-
• Basic
• Pediatric
• Advanced

There are algorithms- clear step by step instructions- that must be used to guarantee uniformity of treatment in all cases.

Advanced Cardiac Life Support Steps

The process starts with a check of the rhythm of the heartbeat. This decides the next step.

For an irregular heartbeat, the heart of ACLS is CPR and quick defibrillation. Monitoring the condition of the person, administering drugs- all of this comes later and depends on the patient getting good, effective CPR. The CPR must be performed with no interruptions of any kind for it to be most effectual. This is contradictory to the earlier guideline which allowed for breaks. Now, the checking of vitals, the inserting of tubes etc. needs to be done simultaneously or with very little time taken.

A key point of advanced cardiac life support is proper chest compressions. For adults, it needs to be between 2 and 2.5 inches and at 100 to 120 compressions per minute. Improper technique can reduce the efficacy of the treatment.

Basic life support is something even a lay-person can provide with proper training; we have heard of enough cases of the Heimlich maneuver saving lives in restaurants and other ordinary settings. CPR and mouth-to-mouth resuscitation can and have helped people come back from trauma. But advanced cardiac life support is a different story all together. It needs to be performed only by trained and professionally-equipped people. Someone, for instance, who’s gone through the gamut of questions and answers to the ACLS pretest and then qualified in the test.

It goes without saying that a patient in need of advanced support, is in deep distress. In such circumstances, chaos is the last thing either the patient or the personnel need. It’s important to establish a chain of command and to adhere to the leader’s instructions. Care must also be taken to keep the other team members informed of every action. In a tense situation, one may need to raise one’s voice to be heard. It must be done so that everyone is in the know of things and can accordingly respond.