Frequently asked questions | ACLS-Algorithms.com

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  1. hybiscus says

    Jeff was very quick to assist to on the phone so I could log in and study again. Thank you for being there-this is my second time using your website and you make it enjoyable to study ACLS. I highly recommend your website!

  2. martha says

    my patient’s life vest had delivered a shock. upon examination, we found the vest had been opened by the patient prior to the shock; conducting gel packs had burst from the patient’s left chest wall to left back wall and vest shocked again. A continuous ekg was run at that point. My theory is that the vest sensors were misaligned due to vest being opened and therefore mis-read rhythm resulting in an inappropriate shock. Also, the vest shocked again. Probably due to gel providing an arc, the vest had mis-read following rhythm. An ekg was run after the first shock and never showed an abnormal rate or rhythm. What would you theorize? P.S. Pt was given emergency treatment with no apparent ill-effects and life vest was collected for evaluation.

    • Jeff with admin. says

      It sounds like the vest defibrillator misread the EKG and shocked inappropriately. If the vest testing comes back normal with no defects in the vest then I would say that this is what occurred. It could have had something to do with the pt. messing with the vest. I am not familiar with the defibrillator vests. I have never used them.

      Kind regards,
      Jeff

    • Jeff with admin. says

      During CPR, the patient would be removed from the ventilator and the BVM (bag vaulve mask) would be attached to the ET (endotracheal tube). Compressions would be >100/min and ventilations would be 1 ventilation every 6-8 seconds. This information can be found on pg. 47 of the AHA ACLS provider manual.

      Kind regards,
      Jeff

  3. Taylor says

    Hi Jeff,
    I was playing sports last weekend and was called over to a player who was laying on the ground, awake and answering questions. He reported that his Internal Cardiac Defibrillator (ICD) had just fired while standing still on the playing field. He did not have any symptoms before the ICD fired, and this was the first time that it had ever gone off. He reported no loss of consciousness, dizziness, chest discomfort, palpitations, shortness of breath, etc.He had a history significant for hypertrophic cardiomyopathy and long-QT syndrome and took lisinopril daily.

    If I discovered this player unconscious, not breathing and pulseless after his ICD fired, what would the process be as for CPR? Is it safe for a provider to give CPR to someone with an actively firing ICD?

    Is there ever a situation where an external defibrillator should be used on this patient? What about epinephrine, amiodarone, etc.?

    After transport to the hospital, what should the management of this patient consist of?

    Thank you for your help.

    Taylor Simpson, PA-C

    • Jeff with admin. says

      1. The process for CPR would be exactly the same except the AED pad should be applied so that it is at least 1 inch away from the AICD. It is safe to be giving CPR to someone while the AICD is firing. The chances of shock is extremely low. I have actually never heard of a case.
      2. It would be appropriate to carry out ACLS in the same way as if the patient did not have the AICD.
      3. The management of the patient after hospital transport would be exactly the same as any other patient except you would want to have the AICD evaluated to ensure that it is working properly.

      I hope that this answers your questions.
      Kind regards,
      Jeff

    • Jeff with admin. says

      The video on the home page explains how to use the site, but if you cannot figure something out, you can call me between 8 a.m. and 11:00 p.m. central time. My technical support number is 316-243-7096.

      Kind regards,
      Jeff

  4. ker3osuedu says

    Jeff,

    I have enjoyed your site so far. My one complaint is that the explanations keep referencing old guidelines. While I am sure that for many people this is beneficial, I would prefer to focus on what is correct now, not what has changed.

    For this learner, I would be helpful to have a AV presentation for each algorithm, not just stating what to do next, but why, and perhaps even reference to the research results that support each step. When I connect the ‘why’ to each step, it is easier for this learner to remember.

    Imagine your target nurse as a new grad, just out of nursing school. While that is not me, it might make it clearer the kind of instruction I am seeking.

    The closest to this I have found was, “Pass the ACLS.” Regretfully, it was made 20 years ago and does not reflect current guidelines.

    If you have any suggestions as to where I might find such a level of depth in teaching this content, I would appreciate any suggestions you may have.

    You have a great site, and I will continue to work my way through it.

    Erik

    • pezkills says

      this is also a concern I have. another example/ contradiction : why are Hypoglycemia and Trauma scratched through, on the “h and T” page…. and then as one scrolls down the explanations of each seem to be intact and included on the list.. are NOT scratched out? seems like if they are wrong to have there , they needed to just be removed, mixed messages. please kindly advise? thanks.

      • Jeff with admin. says

        Hypoglycemia and Trauma for as long as I can remember have been part of the H’s and T’s assessment for ACLS. They were deleted from AHA ACLS provider manual in 2010. Since that time I have continued to try and figure out why they were deleted. I have searched the AHA research documents, the AHA online literature, the AHA Circulation Journal, and discussed this with several providers in order to discover the reason. I have made every effort to find out why they were removed, but I have not found a reasonable answer. Since I have been unable to find a reasonable rational for removing them, I left them on the site as you say “scratched” out. I think that they are an important consideration for anyone making an assessment in an emergency situation where they are using ACLS protocol to treat a patient.

        Kind regards,
        Jeff

  5. ROYA says

    I HAVE NO ISSUE PASSING MEGA CODE, TODAY I PASSED BUT I FAIL THE WRITTEN TEST I DO NOT UNDERSTAND IT, I JUST SING IN TODAY EVERY TEST ON THIS SITE SEEMS VERY SHORT AND EASY FOR ME, SO WHERE DID I GO WRONG? DO YOU THINK YOUR QUESTIONS ARE EASY?

    • Jeff with admin. says

      If you go through all of the practice tests on the site, you should be ready for the written test. If you miss any questions use the rational at the top of each practice test to find out why you missed it. Also if you have any questions while you are going through the practice tests, just post and comment and I will answer.
      You can find the practice tests here.

      Kind regards,
      Jeff

    • Jeff with admin. says

      The retake should not be any harder. If it is just the written exam, you should focus on the practice questions. Make sure you read the rationale for the ones you miss.
      Kind regards, Jeff

  6. RAEWYN JOHNSON says

    I failed twice in th ACLS exam.now am really depressed.i have no idea about ACLS.the third exam is coming at the end of this month i wnat to pass this exam.so plz help me

    • Jeff with admin. says

      I just read your comment. I checked the database to see if you were a member of the site and noticed that you are not.

      I can assure that if you use this site to prepare for the exam/megacode, you will pass. If you don’t I will give you your money back.

      Sign up as a member and then watch the video on the home page. Also read this page: http://www.acls-algorithms.com/acls-study-guide. It will help you use the site most efficiently.

      If you don’t understand something just post your question and I will answer within 8-12 hours.
      You can pass ACLS. You will be amazed at how ready you are after you go through the site.

      You can also call me if you need anything: 316-243-7096.

      Sign up here: https://acls-algorithms.com/non-member-page-2

      Kind regards,

      Jeff

  7. flieswithsun says

    Jeff, I need PALS and CCRN. When are you going to put up a site for those? In the mean time, can you suggest a site that is similar to this to study the PALS and the CCRN? If you havn’t considered doing these certifications, please do. This is the easiest site I have ever done.
    Jeannie Daniel RN, BSN, ICU

  8. Karen Chung says

    ThAnk you so much for this site . Did acls today and passed . I could have gotten a perfect score on written but I question myself on 2 . Have been a neonatal nurse for over 7 years , so acls was new for me . Got this on my iPhone was able to view it over and over that help to reinforce everything . Thanks again great website . I shared it with my friend she pass also . Thanks again . I am preparing for pals u need z similar site.kc

  9. Chris says

    It would be a no brainer for me to purchase if you changed videos from flash to YouTube format. I want to use your site on my iPad.

    Also do you have a recommended order to complete your web based program.

    Thanks.

    • Jeff with admin. says

      All of the videos are MP4 and if your player is up-to-date, the videos should work fine on your IPAD with one exception. The waveform capnography video is embedded from another website and is a flash file. It will not be viewable on ipad/iphone/ipod. I don’t have any control over the file format of this video, but it is a great, short, and simple video.
      As far as sequence for study. The link below will give you some direction for study.
      https://acls-algorithms.com/acls-study-guide
      Please let me know if you have any other questions.

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