Pass ACLS Tip of the Day Paul Taylor

If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it’s possible they could be having a stroke.
The Cincinnati Prehospital Stroke Scale uses the acronym FAST to assess Facial droop – Arm Drift - Speech – and Time.
There are several conditions that can mimic a stroke.
Identification & Treatment of hypoglycemia or hyperglycemia.
Identification & Treatment of hypoxia using a pulse oximeter.
Some seizures, electrolyte imbalance, sepsis, brain tumors, and Bell’s Palsy can also mimic a stroke.
Prehospital providers should transport suspected stroke patients to a stroke center following their local protocols.
Hospital providers should active their stroke team to ensure rapid assessment and treatment.
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Most ACLS medications are given IV push.  But, what happens if we can't get an IV?
When IV access isn't available, we should consider administering our IV medications via intraosseous (IO)or endotracheal tube (ETT) route.
The locations we should place an IO when running a code and a location we should avoid.
The ACLS medications that can be given intraosseous.
Where you can find more information about intraosseous access during resuscitation efforts.
In the absence of an IV or IO, some medications may be given down the endotracheal tube.
Why IO is better for than ETT as an alternative route.
The disadvantages of medication administration via ETT.
Review of the medications that can be given down the tube and how they should be given.
Medications should not be given down the tube when anything other than an endotracheal tube is used as an advanced airway.
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The chain of survival for a cardiac emergency and stroke start the same:
preparedness & recognition of an emergency; activation of EMS; delivery of Advanced Life Support; and transporting to the most appropriate facility.
Depending on where you live, Emergency Medical Services (EMS) may provide prehospital Advanced Life Support (ALS).
ALS ambulances are staffed with paramedics who have training in ACLS skills. 
Paramedics can perform an assessment, obtain a medical history, and provide life-saving care within minutes of recognition.
Why EMS "Destination Protocols" for suspected stroke and STEMI make a difference.
ACLS’s timed benchmarks for:
point of first medical contact to PCI for ST elevation MI; door to tPA for ischemic stroke; and onset of symptoms to EVT for LVO strokes.
EMS may bypass a close hospital to transport a STEMI or suspected stroke patient to a hospital capable of 24/7 PCI or a certified stroke center; because time is heart muscle or brain cells.
Check out the Pod Resource page at passacls.com for links to the "EMS On Air" podcast for links to episodes that look at EMS's role in stroke outcomes in the rural vs urban area.
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Performing good CPR and delivering a shock as soon as possible to a patient in Ventricular  Fibrillation or pulseless V-Tach are the two most critical interventions that have been shown to increase survival from sudden cardiac arrest.
Studies have demonstrated significantly better out-of-hospital cardiac arrest survival outcomes in communities with robust public CPR training and public access/first responder AEDs.
The general use of AED including: indications for use; attaching the AED pads; following verbal prompts; and safely administering a shock.
Following the Adult Cardiac Arrest algorithm while using an AED.
Contraindications to AED use.
General safety considerations to remember.
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For apneic patients without a carotid pulse or patients with only gasping/agonal respirations, we will follow the Adult Cardiac Arrest algorithm.
For pulseless patients that the AED doesn't advise a shock, or if the patient's ECG shows asystole or or a non-perfusing organized rhythm (PEA), we will follow the right side of the algorithm.
Initial steps are aimed at delivery of high-quality CPR to keep the brain and vital organs alive. 
Epinephrine administration.
Placement of an advanced airway.
Considering possible reversible H & T causes of cardiac arrest including three common causes of PEA and their emergent interventions.
When we should discontinue resuscitation efforts and call the code.
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Providing good, high quality, CPR with minimal interruptions and early defibrillation are two keys to improved cardiac arrest outcomes.
A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rate.
Characteristics of good songs that will help us.
Advantages & disadvantages of using a song during CPR.
Selected songs from various genres and time periods from AHA's "Don’t Drop The Beat" playlist on Spotify.
https://open.spotify.com/playlist/2mU2FNAhSOtQwW0hBgQMaK
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Good luck with your ACLS class!