ACLS for the Clinical Pharmacist

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Bradycardia Algorithm:Pacing Always Ends DangerMaintain patient airway; assist breathing as neededGive oxygenMonitor ECG, blood pressure, oximetryEstablish IV access⇓Signs/symptoms of poor perfusion caused by the bradycardia?If yes:⇓Prepare for transcutaneous pacingConsider atropine IV while awaiting pacer; if ineffective beginpacingConsider epinephrine or dopamine infusion while awaiting paceror if pacing ineffective⇓Prepare for transvenous pacingTreat contributing causesConsider expert consultation
Bradycardia Algorithm:Pacing Always Ends DangerMnemonicPacingInterventionTCPNoteImmediately prepare for TCP withserious circulatory compromise due tobradycardia (especially high-degreeblocks) or if atropine failed to increaserateConsider medications while pacing is readied.AlwaysEndsDangerAtropineEpinephrine2-10mcg/minDopamine2-10mcg/kg/minFirst line drug, 0.5mg IV/IO q3-5 5 min(maximum 3mg)Second line drugs to consider if atropineand/or TCP are ineffective. Use withextreme caution
Page 1 and 2: ACLSfor theClinical PharmacistKrist
Page 3 and 4: Why Involve Pharmacist?• Improves
Page 5 and 6: Pharmacist Involvement• Pharmacis
Page 7 and 8: Routes of Medications• IV Push (I
Page 9 and 10: Intraosseous Administration• When
Page 11 and 12: HOW?Medication Administration• Do
Page 13 and 14: Use of Algorithms• Meant to treat
Page 15 and 16: ECG Rhythms• Normal sinus rhythmh
Page 17 and 18: ECG Rhythms• Ventricular Tachycar
Page 19 and 20: Cardiac ArrestManagement1. Pulseles
Page 21 and 22: Asystole and Pulseless ElectricalAc
Page 23 and 24: Asystole and PEA AlgorithmPEAInterv
Page 25 and 26: BasicPharmacologyReview
Page 27 and 28: Vasopressor Therapy• Increases SB
Page 29 and 30: Catecholamine Pharmacology• Bind
Page 31 and 32: Epinephrine Side Effects• Nervous
Page 33 and 34: Vasopressin Rationale• Enhance or
Page 35 and 36: A = Atropine• 1mg IVP/IO every 3-
Page 37 and 38: Atropine Side Effects• Anticholin
Page 39 and 40: ECG Rhythms• Ventricular fibrilla
Page 41 and 42: VF/PVT Algorithm: SCREAMGive 1 shoc
Page 43 and 44: VF/PVT Algorithm: SCREAMSShock360J
Page 45 and 46: Amiodarone• 300mg IVP/IO once, th
Page 47 and 48: Lidocaine• 1-1.51.5 mg/kg first d
Page 49 and 50: ArrhythmiaManagement•Bradycardia
Page 51: ECG Rhythms• Sinus bradycardiahea
Page 55 and 56: Transcutaneous PacingApparatus
Page 57 and 58: Epinephrine• Consider epinephrine
Page 59 and 60: Dopamine Side Effects• Cardiovasc
Page 61 and 62: Tachycardia Algorithm (continued)At
Page 63 and 64: Tachycardia Algorithm• Yes 1-2-3,
Page 65 and 66: Adenosine• To convert SVT: 6 mg r
Page 67 and 68: Diltiazem (Cardizem)• Use if aden
Page 69 and 70: Cases:• Rhythm:• What is this?
Page 71 and 72: Cases:• Rhythm:• What is this?
Page 73 and 74: Other Code Situations• Pulmonary
Page 75 and 76: Take Away Points• Most frequently
Page 77: Supplemental Reading• Cardiovascu

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