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Advanced Cardiac Life Support: A Guide for Nurses, 2nd Edition

ISBN: 978-1-4051-8566-0
328 pages
October 2009, Wiley-Blackwell
Advanced Cardiac Life Support: A Guide for Nurses, 2nd Edition (140518566X) cover image


In the event of an adult cardiac arrest, it is essential to be able to respond rapidly, providing safe and effective care. This new and updated edition of Advanced Cardiac Life Support provides the theoretical background to resuscitation as well as explaining the essential resuscitation skills required to manage an adult cardiac arrest- from the time it occurs until subsequent transfer to the ICU.

The emphasis is on the prevention of cardiac arrest with detailed information on the management of peri-arrest arrhythmias and acute coronary syndromes. Advanced Cardiac Life Support also discussed ethical and legal issues, record keeping, dealing with bereavement, audit, equipment and training- providing an essential quick reference tool for nurses and health care professionals.
  • An evidence-based approach to emergency care based on the latest Resuscitation guidelines
  • A succinct yet comprehensive guide to the management of cardiac arrest
  • Written by an experienced resuscitation training offer who is also a qualified nurse and former CCU Charge Nurse
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Table of Contents

Assessment and emergency treatment of the critically ill patient 31

Chapter summary 43

Chapter 4 Principles of Cardiac Monitoring and ECG Recognition 47

Introduction 47

Learning outcomes 47

The conduction system of the heart 48

The ECG and its relation to cardiac contraction 49

Methods of cardiac monitoring 49

Problems encountered with cardiac monitoring 51

Systematic approach to ECG interpretation 52

Cardiac arrhythmias associated with cardiac arrest 56

Peri-arrest arrhythmias 58

Chapter summary 62

Chapter 5 Bystander Basic Life Support 64

Introduction 64

Learning outcomes 64

Potential hazards when attempting BLS 65

Initial assessment and sequence of actions in bystander BLS 66

Principles of chest compressions 70

Principles of mouth-to-mouth ventilation 73

The recovery position 77

Treatment for foreign body airway obstruction 81

Chapter summary 85

Chapter 6 Airway Management and Ventilation 88

Introduction 88

Learning outcomes 88

Causes of airway obstruction 89

Recognition of airway obstruction 89

Simple techniques to open and clear the airway 90

Use of oropharyngeal and nasopharyngeal airways 94

Insertion of the laryngeal mask airway (LMA) 102

Insertion of the combitube 106

Procedure for application of cricoid pressure 107

Principles of tracheal intubation 111

Methods for ventilation 116

Chapter summary 121

Chapter 7 Defibrillation and Electrical Cardioversion 124

Introduction 124

Learning objectives 125

Ventricular fibrillation 125

Physiology of defibrillation 126

Factors affecting successful defibrillation 127

Safety issues and defibrillation 132

Procedure for manual defibrillation 134

Procedure for automated external defibrillation 138

Synchronised electrical cardioversion 140

New technological advances in defibrillation 143

Chapter summary 144

Chapter 8 Advanced Life Support 147

Introduction 147

Learning objectives 147

Background to the Resuscitation Council (UK) ALS algorithm 148

Overview of the ALS algorithm 149

Chest compressions 160

Precordial thump 165

Reversible causes 167

Drug delivery routes 170

Resuscitation drugs 172

Use of pre-filled syringes 174

Principles of external pacing 176

Chapter summary 179

Chapter 9 Resuscitation in Special Situations 182

Introduction 182

Learning outcomes 182

Life-threatening electrolyte abnormalities 183

Hypothermia 186

Drowning 189

Acute severe asthma 191

Electrocution 195

Pregnancy 197

Poisoning 199

Trauma 202

Cardiovascular collapse or cardiac arrest caused by local anaesthetic 203

Chapter summary 204

Chapter 10 Anaphylaxis 209

Introduction 209

Learning outcomes 209

Definition 209

Incidence 210

Pathophysiology 211

Causes 211

Clinical features and diagnosis 211

Treatment of anaphylaxis 213

Chapter summary 217

Chapter 11 Acute Coronary Syndromes 219

Introduction 219

Learning outcomes 219

Pathogenesis of ACS 219

Classification of ACS 220

Diagnosis of ACS 221

Immediate treatment of ACS 228

Chapter summary 232

Chapter 12 Management of Peri-Arrest Arrhythmias 234

Introduction 234

Learning outcomes 234

Principles of the use of the peri-arrest algorithms 235

Adverse clinical signs associated with peri-arrest arrhythmias 235

Management of bradycardia 236

Management of a tachycardia 238

Chapter summary 242

Chapter 13 Post-Resuscitation Care 244

Introduction 244

Learning objectives 244

Goals of post-resuscitation care 245

Initial assessment priorities 245

Transfer to definitive care 253

Measures to limit damage to vital organs 254

Temperature control and therapeutic hypothermia 257

Prediction of poor outcome 262

Chapter summary 263

Chapter 14 Bereavement 266

Introduction 266

Learning objectives 266

Ideal layout for the relatives room 266

Breaking bad news 267

Telephone notification of relatives 268

Practical arrangements following a death 269

Relatives witnessing resuscitation 270

Chapter summary 272

Chapter 15 Ethical Issues in Resuscitation 273

Introduction 273

Learning outcomes 274

Ethical principles that guide medical practice 274

Historical background to DNAR decisions 275

Importance of DNAR decisions 277

Key messages in Decisions Relating to Cardiopulmonary Resuscitation 278

Overview of the DNAR decision-making process 279

Factors underpinning DNAR decisions 279

Documentation of DNAR decisions 286

Information for patients and relatives 287

Chapter summary 288

Chapter 16 Resuscitation Records 291

Introduction 291

Learning outcomes 291

Why maintaining accurate resuscitation records is important 291

Examples of poor record keeping 292

Factors underpinning effective record keeping 292

Importance of auditing resuscitation records 294

Legal issues associated with record keeping 294

Audit and reporting standards 295

Chapter summary 296

Chapter 17 Resuscitation Training 297

Introduction 297

Learning outcomes 297

Why resuscitation training is important 298

Principles of adult learning 298

Resuscitation training methods 299

Recommendations for resuscitation training for healthcare staff 302

Training mannequins/models 304

Resuscitation Council (UK) courses 304

Chapter summary 306

Index 309

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Author Information

Phil Jevon qualified as an RGN in 1986. He worked on CCU between the years 1987 and 1993 during which time he gained considerable experience in coronary care nursing. He has been the Resuscitation Officer/Clinical Skills Lead at The Manor Hospital, Walsall since 1993 and is an Honorary Clinical Lecturer at the Birmingham Medical School. While working on CCU and since then in his role as a member of the hospital cardiac arrest team, he has got considerable experience in advanced cardiac life support.
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The Wiley Advantage

  • An evidence-based approach to emergency care based on the latest Resuscitation guidelines
  • A succinct yet comprehensive guide to the management of cardiac arrest
  • Written by an experienced resuscitation training offer who is also a qualified nurse and former CCU Charge Nurse
See More


"Praised in its previous edition as a concise source of essential information, this new edition presents the most recent information in an accessible format and serves as an excellent reference source for all cardiologists, radiologists and nuclear medicine physicians". (TMCnet.com, 19 January 2011)
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Advanced Cardiac Life Support: A Guide for Nurses, 2nd Edition (US $53.99)

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