💉

Managing H's and T's in ACLS Care

Apr 29, 2025

Correcting H's and T's in ACLS Care

Overview

The lecture covers how to correct the H's and T's in ACLS care, including:

  • Definitions and management strategies for each condition.
  • Importance of following local protocols.

H's in ACLS

  1. Hypovolemia

    • Signs: Tachycardia, narrow QRS, blood loss (obvious or suspected).
    • Treatment: Fluid replacement, keeping patient warm, transport to hospital.

  2. Hypoxia or Hypoxemia

    • Signs: Bradycardia, cyanosis (lips, fingers, toes, ears).
    • Treatment: Oxygen administration, high-flow oxygen, bag-valve-mask ventilations.

  3. Hypokalemia and Hyperkalemia

    • Hypokalemia (Low Potassium)
      • Signs: Flat T-waves, possible U-wave.
      • Treatment: Confirm with blood labs, IV potassium, lactated ringers if allowed.
    • Hyperkalemia (High Potassium)
      • Signs: Peaked T-waves, wide QRS.
      • Treatment: Sodium bicarbonate, calcium IV, medications to remove potassium.

  4. Acidosis (Hydrogen Ion Excess)

    • Signs: Low amplitude QRS complex, irregular rhythm.
    • Treatment: Supportive care.

  5. Hypothermia

    • Signs: Osborn waves on ECG.
    • Treatment: Warm patient in a controlled manner, use dry and warm blankets.

T's in ACLS

  1. Cardiac Tamponade

    • Signs: Beck's triad (tachycardia, JVD, muffled heart sounds), low blood pressure, narrow QRS.
    • Treatment: Fluids for BP stabilization, supplemental oxygen, rapid transport.

  2. Toxins

    • Signs: Prolonged QT interval, ingestion history.
    • Treatment: Address cause, monitor ECG, treatment varies by toxin.

  3. Tension Pneumothorax

    • Signs: Bradycardia, narrow QRS, unequal breathing, JVD, tracheal deviation.
    • Treatment: Oxygen, chest decompression.

  4. Thrombosis (Pulmonary and Cardiac)

    • Pulmonary Thrombosis
      • Signs: Tachycardia, narrow QRS, shortness of breath, low oxygen saturation, chest pain.
      • Treatment: Supportive care, pain management, oxygen, fluids.
    • Coronary Thrombosis
      • Signs: Abnormal ECG (ST elevation, left axis deviation).
      • Treatment: Pain management, oxygen, nitroglycerin, aspirin.

Conclusion

  • Review of ECG readings for diagnostic purposes.
  • Emphasis on early detection and appropriate management.
  • Importance of adhering to local protocols.

These notes summarize the key information about managing H's and T's in ACLS, providing a structured approach to identifying and treating each condition effectively.

Full transcript