Beste Early Defibrillation podcaster (2024)

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Automated External Defibrillator (AED) 6:23

2d ago6:23

6:23

Performing good CPR and delivering a shock as soon as possible to a patient in Ventricular Fibrillation or pulseless V-Tach are the two most critical interventions that have been shown to increase survival from sudden cardiac arrest. Studies have demonstrated significantly better out-of-hospital cardiac arrest survival outcomes in communities with …

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Asystole & Pulseless Electrical Activity (PEA) 6:57

3d ago6:57

6:57

For apneic patients without a carotid pulse or patients with only gasping/agonal respirations, we will follow the Adult Cardiac Arrest algorithm. For pulseless patients that the AED doesn't advise a shock, the patient's ECG shows asystole, or a non-perfusing organized rhythm (PEA), we will follow the right side of the Adult Cardiac Arrest algorithm…

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Songs To Help Us Deliver Good CPR 4:20

4d ago4:20

4:20

Providing good, high-quality CPR with minimal interruptions and early defibrillation are two key interventions shown to improved cardiac arrest outcomes. A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rat…

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Obtaining a Medical History 5:10

5d ago5:10

5:10

A patient’s medical history will help us identify things that may be causing (or contributing) to their current condition as well as guide our decisions so we provide the safest evidence-based care possible. Examples of information obtained in a medical history that will impact the treatment we provide. There are several mnemonics and memory aids t…

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Antiarrhythmics: Magnesium and Procainamide 5:29

6d ago5:29

5:29

Although magnesium can be used in the treatment of other medical conditions such as eclampsia, asthma, & digitalis toxicity; for ACLS, magnesium is primarily used to treat Torsades de Pointes. Identification of Torsades on the ECG. Administration of a magnesium infusion for stable patients vs slow IV push for patients in cardiac arrest. Procainamid…

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Hypovolemia as a H&T Cause of Cardiac Arrest 4:03

9d ago4:03

4:03

When a patient loses excessive amounts of fluids, we say that they are in a state of hypovolemia. The most obvious cause of hypovolemia is from bleeding. Bleeding can be internal or external and caused by trauma, pathology, or iatrogenic. Classic signs & symptoms of hypovolemic shock. Volume replacement with crystalloids vs blood. Connect with me: …

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Morphine Use for ACS 4:49

10d ago4:49

4:49

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 …

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Maintaining a Chest Compression Fraction (CCF) Above 80% 5:49

11d ago5:49

5:49

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 re…

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Epinephrine and Dopamine Review 6:34

12d ago6:34

6:34

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 durin…

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Delivering Artificial Ventilations 6:19

13d ago6:19

6:19

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 …

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Hypothermia: An H&T Reversible Cause of Cardiac Arrest 4:20

16d ago4:20

4:20

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. Mo…

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Calcium Channel Blockers Used in ACLS 4:21

17d ago4:21

4:21

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 chan…

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Targeted Temperature Management (TTM) & Post-Arrest Care 5:18

18d ago5:18

5:18

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 …

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Nitroglycerine Use for ACS 4:47

19d ago4:47

4:47

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 safe…

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Atrial Fibrillation/Flutter with RVR 5:09

20d ago5:09

5:09

In atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) the electrical impulse for cardiac contraction is in the atria but isn't the normal pacemaker of the heart, the SA node. The ECG characteristics of A-Fib and A-Flutter. Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR). Suggested energy…

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Tablets & Toxins as a H&T Reversible Cause of Cardiac Arrest 4:36

23d ago4:36

4:36

As an ACLS provider you do not need to be familiar with all of the different signs of various types of poisoning. You should be able to obtain a history and know to order toxicology. The majority of toxins don’t have a specific antidote. There are a few toxins for which we have emergency interventions and ACLS providers should be familiar with. Rev…

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When To Use Which ACLS Algorithm 8:44

24d ago8:44

8:44

The ACLS algorithms are designed to make it easier to remember the key interventions we should deliver, and the order in which they should be delivered, to provide the best evidence-based care possible. Generally speaking, if there’s a change in a patient’s condition, we should ensure we’re using the correct algorithm. Three key points to remember …

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Beta Blocker Use in ACLS Algorithms 4:51

25d ago4:51

4:51

Beta blocking medications attach to Beta receptors to inhibit or “block” the effects of epinephrine (adrenaline)and norepinephrine in the body. The primary locations of Beta I, II, and III receptors. Effects of epinephrine & norepinephrine’s stimulation of beta receptors on the heart. Beta blockers effects on the heart. When we should consider the …

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Advanced Airways 7:33

26d ago7:33

7:33

This episode we are reviewing the use of advanced airways in the adult cardiac arrest algorithm. When we should consider insertion of an advanced airway for patients in a shockable vs non-shockable rhythm. In addition to an endotracheal tube (ETT), other ACLS advanced airways include the Laryngeal Mask Airway (LMA) and the Laryngeal Tube airway. Th…

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Antiarrhythmic Use After ROSC 5:00

27d ago5:00

5:00

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient’s vital organs and decreasing cerebral damage. Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arres…

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Hydrogen Ions as a H&T Reversible Cause of Cardiac Arrest 4:36

30d ago4:36

4:36

Hydrogen ions is on one of the Hs in ACLS's H&T reversible causes of cardiac arrest. When considering hydrogen ions as a cause, what we’re looking at is the patient’s pH, or acid/base balance, and conditions that affect it. The body's normal pH. Using patient history, ABGs, & labs to determine acidosis or alkalosis. Common conditions/causes that ma…

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Code Flow Using the Adult Cardiac Arrest Algorithm 8:44

1M ago8:44

8:44

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest. If the patient is in a non-shockable rhythm on the ECG such …

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Medication Review: Aspirin 4:24

1M ago4:24

4:24

For patients exhibiting symptoms consistent with myocardial ischemia, Aspirin is the first medications we should consider along with morphine, oxygen, and nitroglycerine; if indicated & safe. Aspirin's mechanism of action & benefits for Acute Coronary Syndrome (ACS) patients. Contraindications and considerations for aspirin’s use. The dose and rout…

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First & Third Degree AV Blocks 7:25

1M ago7:25

7:25

To pass ACLS, you will need to be able to identify common rhythms on a monitor during your mega code and ECG strips on your written exam. If you don't normally monitor patients as part of your job, I suggest two things: 1. Find a system for ECG interpretation that works well for you; and 2. Practice reading ECGs every day for a few weeks before you…

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Lidocaine & Amiodarone Review 6:44

1M ago6:44

6:44

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine. The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine. Review of Lidocaine dosing and administration …

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Nasopharyngeal Airway (NPA) Review 4:56

1M ago4:56

4:56

The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA). Examples of when a NPA should be considered. Contraindica…

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Tamponade as an H&T Reversible Cause of Cardiac Arrest 5:21

1M ago5:21

5:21

When blood, or other fluids, accumulate in the sac around the heart it’s called a cardiac tamponade or pericardial tamponade. The effects of tamponade on the electrical system and chambers of the heart. Cardiac tamponade can be acute or chronic and caused by traumatic, iatrogenic, or pathological etiologies. Common traumatic events, medical procedu…

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Team Leader and Use of Quick Reference Cards 5:04

1M ago5:04

5:04

Two things have changed in recent years to aid students that don't use ACLS in their daily practice. 1. The role of the team leader; and 2. The ability to use your quick reference cards. The team leader is responsible for assigning tasks and overall direction of the team but can & should ask team members for help. Using closed-loop communication to…

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The Importance of Early CPR & Defibrillation 5:33

1M ago5:33

5:33

Two factors to cardiac arrest survivability that have been clearly shown to make the biggest difference is continuous, high-quality CPR and early defibrillation. The most common dysrhythmia present during the first few minutes of cardiac arrest is ventricular fibrillation (VF). The chance of successful defibrillation decreases every minute that pas…

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Quantitative Waveform Capnography Use in ACLS 5:02

1M ago5:02

5:02

Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care. We can use waveform capnography with, and without, an advanced airway in place. Monitoring end tidal CO2 during rescue breathing. Use of capnography to…

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Guidance from ILCOR: Improving Cardiac Arrest Outcomes 33:44

4M ago33:44

33:44

Join us as we review and explore the key steps presented in the International Liaison Committee on Resuscitation (ILCOR) paper, “Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality of Care and Outcomes.” Our clinical guests dive into the steps and discuss the importance of each for clinicians striving to improve outcomes from cardiac arre…

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AACN NTI24 Preview 10:11

6M ago10:11

10:11

Join us for a preview of ZOLL Medical's education sessions at the 2024 American Association of Critical-Care Nurses National Teaching Institute & Critical Care Exposition (AACN NTI) in Denver, CO. Our guest educators will give an overview of their sessions, focusing on advanced resuscitation techniques and innovations in critical care. Discover the…

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Rapid Response Teams – Structure, Implementation, Impact on Outcomes 26:46

7M ago26:46

26:46

In this episode we delve into Rapid Response Teams (RRT) and explore their implementation, structure, and impact on outcomes. Our guest, Fiona Winterbottom, Clinical Nurse Specialist at Ochsner Health, shares with us the evolution of their program and discusses the details from her 2022 paper, A Patient Safety Solution: A Pre- Post Evaluation of a …

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Exploring the evolving mix of BLS and ACLS nurses and their roles in in-hospital cardiac arrest response 22:58

11M ago22:58

22:58

Today’s in-hospital staffing includes a changing mix of BLS and ACLS nurses and programs for cardiac arrest response must adapt accordingly. In this episode, we explore the changing mix and delve into the experience of how one hospital is tailoring their training and response program to maximize strengths and build confidence. Plus, we learn about …

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Hospital Cardiac Arrest: Response, Outcome, and Training Challenges 16:00

1y ago16:00

16:00

Nurse staffing in the post-pandemic environment has brought new challenges and exacerbated old ones. How these challenges affect in-hospital cardiac arrest response is multi-faceted. In this episode, we discuss how hospitals are overcoming them and ways to help maintain focus on response time and patient care. Special thanks to Tony Ringelstein and…

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