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User:Old Mother Hubbs/Advanced cardiac life support

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Advanced cardiac life support, or advanced cardiovascular life support, often referred to by its acronym, "ACLS", refers to a set of clinical guidelines for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused cardiac arrest, using advanced medical procedures, medications, and techniques.

Overview

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Advanced cardiac life support (ACLS) refers to a set of guidelines used by medical providers to treat life-threatening cardiovascular conditions that will cause or have caused cardiac arrest. ACLS is one part of the larger, evidence-based guidelines for resuscitation published by the American Heart Association (AHA), "American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." The AHA publishes these guidelines as member of the International Liaison Committee on Resuscitation (ILCOR) [1]. Multiple countries and regions have guidelines under different names that are used in the same way as ACLS, some of those countries are also members of ILCOR [2].

Scope

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ACLS guidelines are recommendations on the advanced treatment of cardiac arrest from any cause. ACLS guidelines make recommendations that are in addition to the recommendations of Basic Cardiac Life Support. ACLS guidelines are specific to the advanced medical interventions provided, including medications such as epinephrine and adenosine, procedures like endotracheal intubation and intravenous access, and techniques such as dual-sequential defibrillation. ACLS guidelines include recommendations on advanced treatment for some conditions that commonly commonly cause or complicate cardiac arrest. Some of the conditions that the ACLS guidelines offer recommendations on include cardiac arrhythmias and common reversible causes of cardiac arrest. ACLS guidelines also cover post-arrest care such as targeted temperature management and post-arrest percutaneous coronary intervention [3].

The scope of what ACLS guidelines apply to should not be confused with medical personnel's scope of practice.

Algorithmic Approach

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The implementation of ACLS uses algorithms to streamline the use of the guidelines. These algorithms are a way to format some of the information from the guidelines in a step-wise fashion. The algorithms are not fully inclusive of all the information involved in ACLS. The AHA notes that the algorithms should serve as memory aides and clinicians may need to adjust or deviate from the algorithms as necessary [4].

Example ACLS algorithm: [image placeholder]

International guidelines

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ILCOR

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The International Liaison Committee on Resuscitation (ILCOR) serves as a way for international resuscitation organizations to communicate and collaborate [2]. ILCOR publishes scientific evidence reviews on resuscitation known as "Continuous Evidence Evaluation (CEE) and Consensus on Science with Treatment Recommendations (CoSTRs)" [5]. The ILCOR members as of 2021 are American Heart Association (AHA), European Resuscitation Council (ERC), Heart and Stroke Foundation of Canada (HSFC), Australian Resuscitation Council, New Zealand Resuscitation Council, Resuscitation Council of Southern Africa (RCSA), InterAmerican Heart Foundation (IAHF), Resuscitation Council of Asia (RCA) [2].

Europe and Northern Africa

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33 countries in Europe and northern Africa are members of the European Resuscitation Council (ERC) and participate in the ERC Guidelines [6]. The equivalent portion of the ERC guidelines to ACLS is called "Advanced Life Support" [7].

The Americas

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The Heart and Stroke Foundation of Canada, The Heart Foundation of Jamaica, The Heart & Stroke Foundation of Barbados Inc., The Trinidad and Tobago Heart Foundation, Fundación InterAmerica del Corazón Argentina, Fundación InterAmerica del Corazón Bolivia, and InterAmerican Heart Foundation Caribbean all participate in the AHA Guidelines and ACLS [8].

Australia and New Zealand

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The Australian Resuscitation Council and the New Zealand Resuscitation Council collaborate to produce the Australian and New Zealand Committee on Resuscitation Guidelines [9][10]. The equivalent portion of the ERC guidelines to ACLS is called "Advanced Life Support" [11].

Southern Africa

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The Resuscitation Council of Southern Africa participates in the AHA Guidelines and ACLS [12].

UK

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The Resuscitation Council UK guidelines are based on the ERC Guidelines and the equivalent portion to ACLS is called "Advanced Life Support" [13].

Certification

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AHA ACLS Certification

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The AHA offers a certification in ACLS. This certification is for medical providers and required by many healthcare entities in North America. The ACLS Guidelines should not be confused with the AHA ACLS certification. The certification is based on the guidelines but the guidelines are independent of the certification [14].

History

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ILCOR

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The International Liaison Committee on Resuscitation (ILCOR) was established 1992 to serve as a way for international resuscitation organizations to communicate and collaborate [2].

AHA Guidelines

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In the 2020 update the guidelines were restructured to align with ILCOR recommendations. These changes include the transition since 2015 away from the previous 5-year update cycle to an online format that can be updated as indicated by continuous evidence review. [1]

ERC Guidelines

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The first version of the European Resuscitation Council (ERC) guidelines were developed in 1992. The 2000 ERC guidelines were developed in collaboration with ILCOR. 5-year updates were published from 2000-2015 and annual updates have been published since 2017 [15].

References

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  1. ^ a b Merchant, Raina M.; Topjian, Alexis A.; Panchal, Ashish R.; Cheng, Adam; Aziz, Khalid; Berg, Katherine M.; Lavonas, Eric J.; Magid, David J.; null, null (2020-10-20). "Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 142 (16_suppl_2): S337–S357. doi:10.1161/CIR.0000000000000918.
  2. ^ a b c d "International Liaison Committee on Resuscitation". ilcor.org. Retrieved 2021-11-13.
  3. ^ Panchal, Ashish R.; Bartos, Jason A.; Cabañas, José G.; Donnino, Michael W.; Drennan, Ian R.; Hirsch, Karen G.; Kudenchuk, Peter J.; Kurz, Michael C.; Lavonas, Eric J.; Morley, Peter T.; O’Neil, Brian J. (2020-10-20). "Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 142 (16_suppl_2): S366–S468. doi:10.1161/CIR.0000000000000916.
  4. ^ "Part 6: Advanced Cardiovascular Life Support". Circulation. 102 (suppl_1): I–136. 2000-08-22. doi:10.1161/circ.102.suppl_1.I-136.
  5. ^ "ILCOR CoSTR". costr.ilcor.org. Retrieved 2021-11-13.
  6. ^ "ERC | Bringing resuscitation to the world". www.erc.edu. Retrieved 2021-11-13.
  7. ^ Soar, Jasmeet; Böttiger, Bernd W.; Carli, Pierre; Couper, Keith; Deakin, Charles D.; Djärv, Therese; Lott, Carsten; Olasveengen, Theresa; Paal, Peter; Pellis, Tommaso; Perkins, Gavin D. (2021-04-01). "European Resuscitation Council Guidelines 2021: Adult advanced life support". Resuscitation. 161: 115–151. doi:10.1016/j.resuscitation.2021.02.010. ISSN 0300-9572. PMID 33773825.
  8. ^ "Who We Are – InterAmerican Heart Foundation". Retrieved 2021-11-13.
  9. ^ "Aims and Objectives of the ARC - Australian Resuscitation Council". Retrieved 2021-11-13.
  10. ^ "About Us » New Zealand Resuscitation Council". www.nzrc.org.nz. Retrieved 2021-11-13.
  11. ^ "Guidelines". resus.org.au. Retrieved 2021-11-13.{{cite web}}: CS1 maint: url-status (link)
  12. ^ "Resus - AHA Letter of Support". www.resus.co.za. Retrieved 2021-11-13.
  13. ^ "2021 Resuscitation Guidelines". Resuscitation Council UK. Retrieved 2021-11-13.
  14. ^ "Advanced Cardiovascular Life Support (ACLS)". cpr.heart.org. Retrieved 2021-11-15.
  15. ^ Perkins, Gavin D.; Gräsner, Jan-Thorsen; Semeraro, Federico; Olasveengen, Theresa; Soar, Jasmeet; Lott, Carsten; Voorde, Patrick Van de; Madar, John; Zideman, David; Mentzelopoulos, Spyridon; Bossaert, Leo (2021-04-01). "European Resuscitation Council Guidelines 2021: Executive summary". Resuscitation. 161: 1–60. doi:10.1016/j.resuscitation.2021.02.003. ISSN 0300-9572. PMID 33773824.