MONA is the acronym sometimes used to help us remember the interventions to consider for patients with Acute Coronary Syndrome or ACS.

Morphine's use in the Acute Coronary Syndrome (ACS) algorithm.

Why Morphine is helpful for patients with ACS.

Contraindications and considerations for the safe administration of Morphine.

Morphine as an alternative to nitro for patients with chest pain that take PDE inhibitors.

Common dosing & administration of Morphine.

Monitoring of the patient's level of consciousness, pain, blood pressure, and respirations after administration.

Possible side effects of Morphine administration.

Narcan as an antidote to Morphine if needed.

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Even good CPR is far less efficient at circulating blood than a functioning heart.

The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include:

• Chest compression fraction (CCF);
• Chest compression rate;
• Chest compression depth;
• Allowing for full recoil; and
• Adequate ventilations.

Using real-time feedback devices and ETCO2 to assess CPR quality.

Three tips to limit pauses in CPR compressions to 10 seconds or less.

Limiting interruptions to chest compressions to less than 10 seconds so we can maintain a CCF of 80% requires teamwork and communication.

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Epinephrine and Dopamine are adrenergic agonist used in several ACLS algorithms.

The use of epinephrine for severe anaphylaxis and unstable bradycardia.

Review epinephrine’s effects on blood vessels and bronchioles.

Why epinephrine is helpful for patients with anaphylaxis.

Using an epi drip for unstable bradycardia.

Epinephrine administration during cardiac arrest.

Starting and epinephrine or Dopamine drip for patients that have ROSC.

Review the effects of Dopamine based on mcg/kg/min dosing.

Monitoring the patient and titrating epi or Dopamine drips to prevent harm.

For more information on ACLS medications, check out the pod resource page at passacls.com.

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Providing rescue breathing to apneic patients with a palpable pulse.

Normal end tidal CO2 for patients with a pulse.

Identification of cardiac arrest and our immediate actions.

Providing artificial ventilations during CPR without an advanced airway vs with an advanced airway in place.

Using quantitative waveform capnography to confirm placement of an advanced airway, assess the quality of CPR, and identify ROSC.

The effects of hyperventilating patients in cardiac arrest.

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Hypothermic patients aren't dead until they are warm and dead.

When a patient’s core body temperature drops below 96.8 F (36 C), they are hypothermic.

As the body’s temperature drops below 36 C, hypothermia may further be classified as moderate or severe:

• Moderate if the patient’s body core temp is between 30-34 C; and
• Severe if it's below 30 C.

Modifying the ACLS Adult Cardiac Arrest algorithm for patients with severe hypothermia.

Following the ACLS algorithm for patients with a body core temperature above 30 C.

Methods for rewarming patients with moderate vs severe hypothermia.

Continuation of CPR and ACLS efforts until the patient’s body core temp is above 36 C.

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Calcium is one of the ions that move across the cellular membrane during cardiac contraction and relaxation.

The primary use of calcium channel blockers in ACLS is for the treatment of stable, narrow complex tachycardias refractory to Adenosine and to lower the blood pressure of ischemic stroke patients with severe hypertension.

Use of calcium channel blockers for SVT refractory to Adenosine and A-Fib or A-Flutter with RVR.

Contraindications of calcium channel blockers.

Nicardipine use during the treatment of ischemic strokes.

For more information on ACLS medications, tachycardia, or stroke check out the pod resource page at passacls.com.

Thank you and shout out!

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The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.

Post-arrest care and recovery are the final two links in the chain of survival.

Identification of ROSC during CPR.

Initial patient management goals after identifying ROSC.

The patient’s GCS/LOC should be evaluated to determine if targeted temperature management (TTM) is indicated.

Patients that cannot obey simple commands should receive TTM for at least 24 hours.

Monitoring the patient’s core temperature during TTM.

Why we should cool unresponsive post-arrest patients.

Patients can undergo EEG, CT, MRI, & PCI while receiving TTM.

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Nitroglycerine is vasodilator that affects peripheral blood vessels and coronary arteries.

Because of its widespread dilation effects on blood vessels, nitro can quickly lower a patient’s blood pressure, sometimes to the point of making a patient hypotensive.

Assessment of vital signs prior to administering nitro is necessary to ensure patient safety.

Indications for use of nitroglycerine.

Nitroglycerine's contraindications & considerations for use.

Effects of nitro on patients taking PDE inhibitors.

Administration of nitroglycerine to patients with ischemic chest pain. (ACS)

Considerations for patients that took their home nitroglycerine.

Monitoring patient's pain and vital signs after nitro administration.

Connect with me:

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Give back & help others. Your support will help cover the monthly cost of software and podcast & website hosting. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.

Good luck with your ACLS class!