ACLS in a Nutshell
Graphic at a Glance
- The provider can use these quick tips to quickly refer to the care of the ACLS patient.
- This information includes a mnemonic that can help the provider remember the patient’s initial management (VOMIT).
- A second mnemonic, CASH, can help the provider remember symptoms that are important inpatient management.
- The mnemonic DATE can help the provider remember treatments for symptomatic patients.
Related Video – Understanding ACLS in a Nutshell
Goals for ACLS in a Nutshell
The provider will understand the tips and tricks for ACLS:
- Prioritize care based on the VOMIT mnemonic
- Recognize symptoms based on the CASH mnemonic
- Administer care based on heart rate
ACLS in a Nutshell Explained
This graphic was created to present a quick way for the provider to remember mnemonics to evaluate the patient who might require basic or advanced life support.
Box 1: The VOMIT mnemonic
The clinician should respond with first things first:
- Vital signs
- Oxygen
- Monitor
- IV
- Treatment based on symptoms
Some vital signs include blood pressure, heart rate, and respiratory rate.
Box 2: Symptoms based on CASH mnemonic
The team attempts to answer the question of whether the patient is symptomatic:
- Chest pain
- Altered mentation
- Short of breath
- Hypotensive
One of the symptoms is chest pain.
If the patient is symptomatic, proceed to Box 3; if not, proceed to Box 4.
Box 3: Decision point: Determine the heart rate
If the heart rate is < 50 bpm, proceed to Box 5; if the heart rate is > 150, proceed to Box 6.
Box 4: Decision point: Determine the heart rate
If the heart rate is < 50 bpm, proceed to Box 7; if the heart rate is > 150, proceed to Box 8.
Box 5: Remember the mnemonic DATE
For the unstable patient with a slow heart rate, the team considers administration of:
- Dopamine
- Atropine (1st choice)
- Transcutaneous pacing
- Epinephrine
Box 6: Cardioversion or defibrillation
For an unstable patient with a fast heart rate, the team considers synchronized cardioversion (or defibrillation for a wide or irregular rhythm).
Related Video – Synchronized Cardioversion for Tachycardia
Box 7: Monitor
For a stable patient with a slow rate, the team continues to monitor for a change in condition.
Box 8: Determine SVT vs. Wide QRS tachycardia
For a stable patient with a fast rate, it is critical to determine if the rhythm is SVT or Wide QRS tachycardia with a pulse. For SVT, attempt vagal maneuvers or adenosine. For wide QRS tachycardia, administer amiodarone over 10 minutes.
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Editorial Note
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