NLE Emergency & Critical Care Nursing — Basic & Advanced Life Support (CPR/ACLS)Concept Map

CPR/ACLS Complete Concept Hierarchy

Comprehensive mind map showing the hierarchical relationships of all major concepts in CPR/ACLS, organized from the central concept outward through foundational elements (Chain of Survival, BLS), core technical skills (compressions, airway, defibrillation), advanced interventions (ACLS rhythms and drugs), special situations (choking, reversible causes), and supporting processes (team dynamics, post-arrest care). This structure mirrors the clinical decision-making progression a nurse follows during a cardiac arrest.

BLS Algorithm: C-A-B Sequence and Decision Tree

Step-by-step flowchart of the BLS algorithm emphasizing the C-A-B sequence (Compressions, Airway, Breathing). Incorporates all critical decision points: responsiveness assessment, breathing-pulse evaluation, compression delivery, rescue breath technique, AED availability and application, rhythm analysis, and endpoint decision for ROSC versus continued resuscitation. This is the procedural roadmap nurses execute during initial cardiac arrest response.

ACLS Rhythm Management and Drug Therapy Algorithm

ACLS algorithm showing the divergence between shockable rhythms (VF/pulseless VT) requiring defibrillation and antiarrhythmics, versus non-shockable rhythms (asystole/PEA) requiring early epinephrine and aggressive search for reversible causes. Incorporates critical timing: epinephrine every 3-5 minutes, 2-minute reassessment cycles, amiodarone dosing, and endpoint criteria (ROSC or continued arrest). This reflects the real-time decision structure used in ACLS courses and actual resuscitations.

Compression Quality Maintenance and Team Rotation

Procedural flowchart for maintaining high-quality compressions through systematic team rotation every 2 minutes. Emphasizes continuous quality monitoring, fatigue assessment, smooth compressor changeovers, and use of quantitative feedback devices. This addresses the practical reality that compression quality degrades rapidly even when rescuers do not perceive fatigue, and demonstrates how organized team dynamics prevent this critical failure mode.

Choking Management Decision Tree: Responsive vs Unresponsive

Decision tree for managing foreign-body airway obstruction, distinguishing between mild obstruction (encourage coughing, do not intervene) and severe obstruction requiring immediate physical intervention. Branches by patient age: adults/children receive abdominal thrusts, infants receive back slaps plus chest thrusts (never abdominal thrusts in infants), and pregnant/obese patients receive chest thrusts. Also addresses the critical transition when a choking victim becomes unresponsive: start CPR immediately and remove only visually apparent objects—no blind finger sweeps.

Reversible Causes Search: Hs and Ts Investigation Protocol

Systematic protocol for investigating potentially reversible causes during cardiac arrest, especially in non-shockable rhythms (asystole/PEA) where finding and treating the underlying cause is crucial. Organizes causes into two categories: Hs (Hypovolemia, Hypoxia, Hydrogen ion/acidosis, Hypo-/Hyperkalemia, Hypothermia) and Ts (Tension pneumothorax, Tamponade, Toxins, Thrombosis pulmonary/coronary), with associated diagnostic clues and treatments for each. This mindset of 'search while you compress' is essential for improving outcomes in presumed non-shockable arrests.

Post-ROSC Management and Ongoing Care Priorities

Post-return of spontaneous circulation (ROSC) management pathway emphasizing the critical transition from resuscitation to post-arrest stabilization and cause identification. Organized into immediate priorities (airway protection, oxygenation optimization, perfusion maintenance), diagnostic phase (EKG, labs, cause identification), and therapeutic phase (targeted temperature management if comatose, vasopressor support, organ system monitoring). This reflects the evidence that secondary brain injury prevention and cause treatment in the hours after ROSC significantly impact neurologic outcome and survival.

Cardiac Arrest States and Transitions

State diagram illustrating the progression through cardiac arrest states from witnessed or unwitnessed collapse, through initial rhythm assessment (shockable vs non-shockable), through resuscitation cycles with 2-minute reassessments, and branching to either ROSC with post-arrest care or continued/prolonged resuscitation. Shows the non-linear nature of arrest management where rhythm may change, secondary causes may be discovered, and outcomes branch to either successful intensive care management or terminal states. This conceptual model helps nurses understand where they are in the arrest sequence and what expectations and priorities apply.

Time-Dependent Survival Rates in Witnessed Cardiac Arrest

Pie chart demonstrating the profound impact of time-to-defibrillation on survival outcomes in witnessed ventricular fibrillation arrests. Survival decreases roughly 7-10% per minute without defibrillation, falling from over 50% when shocked within 3 minutes to single digits when defibrillation is delayed beyond 10 minutes. This visualization emphasizes why rapid access to AED and immediate defibrillation are cornerstones of the Chain of Survival, and why bystander CPR and public AED deployment are critical community-level interventions in the Philippines.