ACLS protocol utilizes the highest quality pharmaceuticals in the field of emergency medicine. In order to prevent further injury, ACLS trained professionals initiate IV access or intubation in certain situations where immediate intervention is needed, such as serious cardiac events and stroke. In pre-hospital settings, these pharmaceuticals are vital to keep the person alive and stable during transport to a medical facility.
The pharmacology used by ACLS providers is the same used in hospitals by physicians working with the same kind of medical emergencies. ACLS certification courses provide a vast amount of information about these drugs, and trainees learn to determine which drug to use in any given clinical situation through the different ACLS algorithms.
Here are some of the most commonly used drugs for various cardiovascular events utilized in ACLS protocol:
Ventricular Fibrillation/ Ventricular Tachycardia
- Vasopressin: Used in the pulseless arrest algorithm to raise blood pressure and induce moderate vasoconstriction. Has been shown to be more effective than epinephrine during asystolic cardiac arrest.
- Epinephrine: A drug with powerful vasoconstrictive effects, used to increase cardiac output. Can be given through IV/IO and endotracheal tube.
- Amiodarone: Anti-arrhythmic agent used for various tachyarrythmias, administered through IV/IO.
- Lidocaine: Used as an alternative in VT/VF cardiac arrest when amiodarone is ineffective.
Bradycardia
- Epinephrine: Increases heart rate, heart contractility, and conductivity through the AV node.
- Atropine: Increases activity in the SA node by blocking the vagas nerve and increasing heart rate. Most commonly used drug for bradycardia.
- Dopamine
Tachycardia
- Adenosine: The main drug used to treat supraventricular tachycardia (stable narrow-complex). It interrupts re-entry through the AV node and restores normal sinus rhythm. It is quickly absorbed by red blood cells before being metabolized by the body.
- Beta-blockers: Neutralizes the effects of stress hormones and epinephrine (adrenaline), which can trigger or exacerbate tachyarrhythmias.
- Dilitiazem
- Digoxin
- Amiodarone
Asystole/PEA
- Vasopressin
- Epinephrine
Acute Coronary Syndomes
- Aspirin
- Oxygen
- Morphine
- Nitroglycerin
Acute Stroke
- tPA-tissue: Breaks down blood clots in the treatment of embolic or thrombotic stroke.
- Glucose (D50)
- Plasminogen Activator
All of these drugs have specific conditions and dosages for use. These drugs are very powerful, and also come with some serious side-effects, so ACLS providers must exercise caution and accurately determine the correct drug and dosages to use. ACLS training features comprehensive algorithms which professionals follow step-by-step to ensure that optimal pharmaceutical care is provided.
Our ACLS Pharmaceuticals Review & Tips:
As previously noted, ACLS is a series of medical procedures put in to action using step by step methods, in order to save a patient suffering from cardiac arrest or certain other similar medical emergencies. In addition to procedures and techniques, drugs and medications are also used to help manage a patient and bring him back to life.
There are several sets of medications that are administered throughout the algorithms to keep the patient recovering, step by step. Furthermore, certain medications are to be administered immediately or in pre-hospital settings while other sets of medications are to be administered in the emergency room afterwards.
For ACLS students, it is very important to thoroughly understand a few points regarding medication administration:
- It is very important to know the nature of the drug/drugs
- It is crucially important to understand the proper time for administering medications
- It is also very important to understand the proper method of drug administration
- The affect of medication is also to be understood, carefully.
ACLS medications are administered for several purposes i.e. to keep a person alive and protecting and preparing the heart for later interventions.
The American Heart Association has provided protocols for proper medication distribution and regularly updates these protocols from time to time. Hence, it is very important for all medical professionals to learn the ACLS protocols and keep updating themselves as needed. Here is a short outline of the medications administered throughout the Advanced Cardiac Life Support algorithm.
Pre-Hospital Medications
At the beginning of the Life Support procedure, there are several drugs that can be administered. These medications are aimed at instant relief and preparing a patient for further treatment. These medications may be administered:
- Orally
- Through Intravenous Injections also known as IV
- Injected in Bones/IO
- Through ET tube
Only Paramedics are certified for drug administration and EMTs are not allowed to administer medications in an ambulance. However, under some conditions they are allowed to administer nitroglycerin for relieving chest pain and aspirin.
The typical medications that are used during pre-hospital settings or in an ambulance are:
- Atropine
- Diltiazem
- Adenosine
- Epinephrine
- Lidocaine
- Magnesium
- Verapamil
- Vasopressin
There are certain other drugs that are carried by ambulance personnel for relieving chest pain and other symptoms arising from cardiac arrest, aside from the aforementioned pharmaceuticals. A few of them are:
- Aspirin
- Dopamine
- Sodium bicarbonate
- Morphine
- Calcium
Emergency Room Medications
After the patient reaches the emergency room, he is to be administered with several other medications for proper treatment. These drugs may belong to the primary or secondary groups of Advance Cardiac Life Support drugs. Primary ACLS medications are those which are to be administered to keep the patient alive and are generally administered in pre-hospital settings. However, due to storage or cost issues, there are certain drugs that cannot be carried in the ambulance and are given to the patient as soon as he arrives to the emergency room. On the other hand, secondary drugs are those which are to be administered to weed the root cause out.
The medications that are normally administered in the emergency room settings are:
- Digoxin or Amiodarone for normalizing abnormal heart rhythms
- Drugs for flushing clots out of heart
- Drugs for normalizing Blood pressure i.e. Beta blockers or ACE inhibitors
- Drugs for thinning blood to prevent clot formation inside heart or arteries.
In addition to these drugs, several other drugs are detailed in the ACLS protocols issued by the American Heart Association. The guidelines for Advanced Cardiac Life Support provide detailed algorithms for treating several cardiac conditions that may end up in arrest and procedures to fight these conditions in order to save lives. When proper clinical guidelines are coupled with proper or prescribed drugs, the recovery of patients is effective and fastidious.
Ventricular Fibrillation
Asystole/PEA
Bradycardia
Tachycardia
- Adenosine
- Diltiazem
- Beta-blockers
- Amiodarone
- Digoxin
- Verapamil
- Magnesium
Acute Coronary Syndrome
- Oxygen
- Aspirin
- Nitroglycerine
- Morphine
- Fibrolynic Therapy
- Heparin
- Beta-blockers
Acute Stroke Care
- tPA (tissue plasminogen activator)
- Glucose
- Labetolo
- Nitroprusside
- Nicardipine
- Aspirin
No comments:
Post a Comment