Advanced Cardiac Life Support (ACLS) for Medical and Surgical Teams

Table of Contents

Advanced Cardiac Life Support (ACLS) saves lives, but only when teams know how to use it together, not just individually. A 2020 study in Resuscitation found that about 700,000 people experience cardiac arrest each year in the U.S. Survival rates for in-hospital cardiac arrest vary widely, from 8.3% to 31.4%, based on how closely teams follow ACLS protocols. Yet in many hospitals, medical and surgical teams still hesitate or fumble during code situations, unsure of roles or next steps.

A common mistake is thinking ACLS is only for emergency or critical care teams. But cardiac arrests can happen anywhere, in a recovery room, on a surgical floor, or during routine rounds. Without clear coordination, even trained professionals can lose precious time. acls online classes training does more than teach algorithms. It builds trust, communication, and readiness across the entire care team. When everyone knows what to do and when to act, outcomes improve. Want to learn how ACLS brings teams together and improves patient care? Keep reading to find out.

What Is Advanced Cardiac Life Support?

Advanced Cardiac Life Support (ACLS) is a set of clinical guidelines used to treat people who are experiencing serious heart problems like cardiac arrest, stroke, or dangerous arrhythmias. It goes beyond basic CPR by including advanced skills such as managing airways, using medications, reading ECGs, and using defibrillators. ACLS is designed for healthcare professionals who respond to cardiovascular emergencies, like doctors, nurses, paramedics and hospital staff.

What Are The Key Components of ACLS for Medical Teams?

Medical and surgical teams often care for very sick patients or people going through surgery. These patients can suddenly have heart problems, especially during or after surgery. If this happens, the team must act fast using advanced cardiac life support to help the patient survive. Each part of ACLS is important. Medical and surgical teams must follow each step carefully to treat the patient safely.

Recognizing a Heart Emergency

The first and most critical step in ACLS is recognizing that the patient is in cardiac arrest. This means the person is unresponsive, not breathing normally, and has no detectable pulse. It can involve dangerous rhythms like ventricular fibrillation (VF), where the heart quivers instead of pumping, or pulseless ventricular tachycardia (VT), where the heart beats rapidly without a pulse. Other life-threatening rhythms include asystole, shown as a flat line and pulseless electrical activity (PEA), where electrical signals are present but there’s no heartbeat. Rapid recognition of these signs allows the team to act before brain damage or death occurs.

Giving Chest Compressions (CPR)

High-quality CPR is the most important part of ACLS. The team must push hard and fast in the centre of the chest, at a rate of 100–120 times per minute and a depth of 5–6 cm. This helps keep blood flowing to the brain and heart. CPR should start as soon as possible and should only stop for a few seconds when giving a shock or checking the rhythm. During surgery, it can be harder to do CPR, so the team must work together carefully to avoid delays.

Helping the Patient Breathe

When the heart stops, breathing also stops. The team must open the airway and start giving oxygen right away. At first, a bag-mask device is used to push air into the lungs. If needed, a breathing tube (endotracheal tube) is placed for better oxygen delivery and airway control. This is called advanced airway management. Oxygen levels should be monitored using pulse oximetry and end-tidal CO₂ (capnography) is often used to check the quality of chest compressions and confirm tube placement. Proper airway support helps reduce brain injury and increases the chance of survival with good outcomes.

Using a Defibrillator

Defibrillation is used when the patient has a shockable rhythm, like VF or pulseless VT. A defibrillator sends a controlled shock through the chest to reset the heart’s electrical activity. Every minute without defibrillation lowers survival by 7–10%, so speed is critical. Medical and surgical teams must recognize shockable rhythms quickly and operate the defibrillator with precision. Pads should be placed correctly on the chest, and safety must be ensured before delivering the shock. After the shock, CPR should resume immediately without delay, and the rhythm should be reassessed every two minutes to guide the next steps.

Giving Emergency Medicines

ACLS uses specialized medications to restart or support the heart during a cardiac emergency. Common drugs include epinephrine (adrenaline), which helps the heart pump and improves blood flow, and amiodarone or lidocaine for abnormal heart rhythms. Atropine is used when the heart beats too slowly, while magnesium is given for certain rhythm problems like torsades de pointes. These medications are usually given through a vein (IV) or, in urgent cases, through the bone using an intraosseous line.

Care After the Heart Starts Again

Once the heartbeat returns (this is called return of spontaneous circulation or ROSC), the patient needs very careful care. The team must check oxygen levels, blood pressure, and brain activity. In some cases, doctors may cool the body (called targeted temperature management) to protect the brain. In surgical cases, the team also needs to manage blood loss, anaesthesia effects, and wounds. The patient is usually moved to the ICU for further monitoring.

Common Challenges and Misconceptions in ACLS Implementation

Implementing advanced cardiovascular life support effectively requires not only technical skills but also sound judgment and teamwork. However, healthcare teams often face challenges and hold certain misconceptions that can impact patient outcomes. Some of the common misconceptions are:

Misconception / Challenge	Clarification / Impact
Hesitation in Decision-Making	Delays can reduce survival. ACLS requires confident, timely action based on known protocols.
Misinterpretation of Guidelines	Stress can lead to errors. Ongoing education and simulations help keep skills sharp.
Poor Team Communication	Without clear roles and leadership, care becomes uncoordinated. Team briefings are essential.
Over-Reliance on Equipment	Technology supports, but does not replace, core skills like CPR and airway management.
Assuming ACLS Is Only for Specialists	ACLS is vital for many healthcare providers, not just cardiologists or emergency doctors.
Thinking ACLS Only Covers Cardiac Arrest	ACLS also manages stroke, respiratory failure, and includes airway and neurological support.

Advancements in ACLS: Staying Updated with the Latest Guidelines

Staying current with advanced cardiovascular life support guidelines is essential for improving survival rates and team performance during critical events. The American Heart Association (AHA) updates its recommendations every five years based on new research and global data. Each update reflects changes that optimize care, reduce delays and improve team coordination.

Emphasis on High-Quality CPR

Recent guidelines continue to stress the importance of high-quality chest compressions—at least 100–120 compressions per minute and 5–6 cm deep. Minimizing interruptions and allowing full chest recoil are now central to training. Real-time feedback devices are encouraged to help teams monitor their CPR performance and correct errors during resuscitation.

Streamlined Use of Medications

Updated protocols provide clearer guidance on drug timing and dosage. Epinephrine should be given as early as possible in non-shockable rhythms. Amiodarone and lidocaine remain second-line treatments for shockable rhythms. There’s also a stronger focus on avoiding unnecessary medications that may not improve outcomes.

Team Dynamics and Communication

Modern ACLS training now includes structured team roles and communication. Closed-loop communication, role clarity, and designated team leaders are standard. This helps avoid confusion and ensures smoother interventions, especially in high-stress environments like the ICU or OR.

Focus on Post-Resuscitation Care

The latest updates highlight the importance of post–cardiac arrest care, including targeted temperature management, neurological assessments, and hemodynamic monitoring. Managing the patient after return of spontaneous circulation (ROSC) is just as critical as initial resuscitation.

ACLS: A Critical Life-Saving System for Healthcare Teams

Advanced Cardiac Life Support is an important skill for all medical and surgical teams in hospitals. When a patient’s heart stops or beats dangerously, fast and correct action can save their life. ACLS includes checking heart rhythms, giving CPR, using defibrillators, helping the patient breathe, giving emergency drugs, and working as a team.

With regular training and good teamwork, hospital staff can provide safe and effective care during heart emergencies. ACLS is not just a medical procedure; it is a system that helps save lives every day. So, take the first step today by enrolling in an ACLS course and make a difference.

References

Share this post: