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

Concept

Chain of Survival

Sub Concepts

• Early Recognition and Emergency Activation
• Early High-Quality CPR
• Rapid Defibrillation
• Effective Advanced Care
• Integrated Post-Arrest Care

Relationship To Central

Foundation framework for understanding cardiac arrest management outcomes

Concept

Basic Life Support (BLS)

Sub Concepts

• C-A-B Sequence
• Scene Safety Assessment
• Responsiveness and Breathing Check
• Pulse Assessment
• Emergency System Activation

Relationship To Central

Core foundational skill preceding ACLS interventions

Concept

High-Quality Chest Compressions

Sub Concepts

• Compression Rate: 100-120 per minute
• Compression Depth: Adult 5-6 cm
• Pediatric Compression Depth: 1/3 AP diameter
• Infant Compression Depth: ~4 cm
• Full Chest Recoil
• Hand Position: Sternum Lower Half
• Compression-to-Ventilation Ratio 30:2
• Compressor Switching Every 2 Minutes
• Minimize Interruptions
• Compression Fraction ≥60%

Relationship To Central

Most critical life-saving intervention in cardiac arrest

Concept

Airway and Breathing Management

Sub Concepts

• Head-Tilt/Chin-Lift Maneuver
• Jaw-Thrust (Trauma Suspected)
• Rescue Breaths: 2 per cycle
• Breath Delivery: ~1 second per breath
• Visible Chest Rise Confirmation
• Avoid Excessive Ventilation
• Advanced Airway Placement
• Continuous Compressions with Advanced Airway

Relationship To Central

Secondary but essential component of BLS and ACLS

Concept

Automated External Defibrillator (AED)

Sub Concepts

• Power On and Voice Prompts
• Pad Placement: Right Upper Chest and Left Lower Lateral
• Bare, Dry Chest Requirement
• Rhythm Analysis and Pause
• Shock Delivery and Patient Clearance
• Immediate CPR Resume Post-Shock
• Special Situations: Medication Patches, Pacemakers, Wet Chest
• Pediatric Pads/Attenuator Use

Relationship To Central

Critical adjunctive technology for rapid rhythm defibrillation

Concept

ACLS Rhythms and Drug Therapy

Sub Concepts

• Shockable Rhythms: VF and Pulseless VT
• Non-Shockable Rhythms: Asystole and PEA
• Epinephrine Administration: 1 mg IV/IO every 3-5 minutes (1:10,000 concentration)
• Amiodarone: 300 mg first dose, 150 mg second dose
• Lidocaine as Alternative Antiarrhythmic
• Rhythm Reassessment Every 2 Minutes

Relationship To Central

Advanced interventions based on cardiac rhythm identification

Concept

Reversible Causes of Arrest

Sub Concepts

• Hs: Hypovolemia, Hypoxia, Hydrogen Ion, Hypo-/Hyperkalemia, Hypothermia
• Ts: Tension Pneumothorax, Tamponade, Toxins, Thrombosis

Relationship To Central

Critical diagnostic focus during resuscitation to guide treatment

Concept

Foreign-Body Airway Obstruction (Choking)

Sub Concepts

• Mild vs Severe Obstruction Classification
• Abdominal Thrusts (Heimlich Maneuver)
• Chest Thrusts (Pregnant/Obese Persons)
• Infant Back Slaps and Chest Thrusts
• No Abdominal Thrusts in Infants
• Unresponsive Victim: CPR and Visible Object Removal
• No Blind Finger Sweeps

Relationship To Central

Related acute airway emergency requiring different management

Concept

Post-Arrest Care (After ROSC)

Sub Concepts

• Return of Spontaneous Circulation (ROSC) Indicators
• Airway Protection and Oxygenation
• Target Oxygen Levels (Avoid Hyperoxia)
• Carbon Dioxide Management
• Perfusion Support and Vasopressors
• Mean Arterial Pressure (MAP) Targets
• Targeted Temperature Management
• Precipitating Cause Identification and Treatment

Relationship To Central

Essential continuation of care to prevent secondary complications

Concept

Team Dynamics and Leadership

Sub Concepts

• Designated Team Leader
• Clear Role Assignment
• Closed-Loop Communication
• Verbal Confirmation of Orders
• Time and Cycle Count Call-Outs
• Safety Culture: Speaking Up About Errors
• Quantitative Feedback Devices
• End-Tidal Carbon Dioxide Monitoring
• Post-Code Debriefing

Relationship To Central

Organizational framework essential for effective resuscitation

Concept

Complications and Consequences

Sub Concepts

• Rib Fractures
• Sternal Fracture
• Gastric Inflation
• Excessive Ventilation Harms
• Prevention Strategies

Relationship To Central

Expected outcomes of effective CPR requiring patient monitoring

Concept

Public Education and Bystander CPR

Sub Concepts

• Early Recognition Teaching
• Hands-Only CPR for Untrained Bystanders
• Continuous Compressions Without Breaths
• AED Awareness and Access
• Time-Dependent Survival Impact

Relationship To Central

Community-level intervention for improving cardiac arrest outcomes

To

Early Recognition and Emergency Activation

From

Chain of Survival

Strength

strong

Relationship

First link in the survival chain; requires rapid recognition of cardiac arrest and immediate EMS activation

To

Basic Life Support

From

Chain of Survival

Strength

strong

Relationship

BLS implements the second and third links of the chain: early high-quality CPR and rapid defibrillation

To

Post-Arrest Care

From

Chain of Survival

Strength

strong

Relationship

Post-arrest care completes the fifth link of the chain: integrated care after ROSC to prevent secondary injury

To

C-A-B Sequence

From

Basic Life Support

Strength

strong

Relationship

C-A-B is the foundational procedural algorithm for delivering BLS

To

High-Quality Chest Compressions

From

C-A-B Sequence

Strength

strong

Relationship

The C (Compressions) component emphasizes that compressions are the primary life-sustaining intervention

To

Airway and Breathing Management

From

C-A-B Sequence

Strength

strong

Relationship

The A-B (Airway and Breathing) components follow compressions but are essential for oxygenation

To

Compression Rate: 100-120 per minute

From

High-Quality Chest Compressions

Strength

strong

Relationship

Rate is a measurable, monitorable parameter of compression quality

To

Compression Depth: Adult 5-6 cm

From

High-Quality Chest Compressions

Strength

strong

Relationship

Depth is a measurable, monitorable parameter of compression quality; inadequate depth reduces cardiac output

To

Full Chest Recoil

From

High-Quality Chest Compressions

Strength

strong

Relationship

Recoil allows cardiac refilling; leaning on the chest during recoil phase prevents effective circulation

To

Minimize Interruptions

From

High-Quality Chest Compressions

Strength

strong

Relationship

Interruptions in compressions dramatically reduce the effective compression fraction and cardiac output

To

Compressor Switching Every 2 Minutes

From

High-Quality Chest Compressions

Strength

strong

Relationship

Fatigue degrades compression quality rapidly; systematic switching preserves quality and compression fraction

To

Basic Life Support

From

Automated External Defibrillator

Strength

strong

Relationship

AED is used adjunctively with BLS to provide rapid defibrillation for shockable rhythms

To

Shockable Rhythms: VF and Pulseless VT

From

ACLS Rhythms and Drug Therapy

Strength

strong

Relationship

VF and pVT require immediate defibrillation followed by CPR and drugs including epinephrine and amiodarone

To

Non-Shockable Rhythms: Asystole and PEA

From

ACLS Rhythms and Drug Therapy

Strength

strong

Relationship

Asystole and PEA are not shocked; management focuses on CPR, early epinephrine, and treating reversible causes

To

Reversible Causes of Arrest

From

Non-Shockable Rhythms: Asystole and PEA

Strength

strong

Relationship

When standard ACLS fails to achieve ROSC in asystole/PEA, aggressive search for and treatment of reversible causes becomes priority

To

Hs: Five Metabolic Causes

From

Reversible Causes of Arrest

Strength

strong

Relationship

Five potentially reversible metabolic derangements (hypovolemia, hypoxia, acidosis, electrolyte abnormalities, hypothermia)

To

Ts: Eight Mechanical and Toxicological Causes

From

Reversible Causes of Arrest

Strength

strong

Relationship

Eight potentially reversible mechanical or toxicological conditions (pneumothorax, tamponade, toxins, thrombosis)

To

Mild vs Severe Obstruction Classification

From

Foreign-Body Airway Obstruction

Strength

strong

Relationship

Management differs fundamentally based on whether the victim can still cough and exchange some air

To

Abdominal Thrusts and Chest Thrusts

From

Foreign-Body Airway Obstruction

Strength

strong

Relationship

These are the definitive interventions for severe choking in responsive adults and children

To

Infant Back Slaps and Chest Thrusts

From

Foreign-Body Airway Obstruction

Strength

strong

Relationship

Different technique for infants to avoid abdominal organ injury

To

Airway Protection and Oxygenation

From

Post-Arrest Care After ROSC

Strength

strong

Relationship

First priority after ROSC is securing the airway and avoiding secondary hypoxic injury

To

Targeted Temperature Management

From

Post-Arrest Care After ROSC

Strength

strong

Relationship

Therapeutic hypothermia (32-36°C) in comatose post-ROSC patients reduces neurologic injury

To

High-Quality Chest Compressions

From

Team Dynamics and Leadership

Strength

moderate

Relationship

Effective team leadership and closed-loop communication ensure compressions are monitored, maintained, and switched systematically

To

ACLS Rhythms and Drug Therapy

From

Team Dynamics and Leadership

Strength

moderate

Relationship

Team leader directs rhythm interpretation, drug administration, timing, and verification to prevent errors

To

High-Quality Chest Compressions

From

Complications and Consequences

Strength

moderate

Relationship

Rib fractures and sternal fracture are predictable consequences of effective CPR; excessive ventilation is an avoidable error

To

Chain of Survival

From

Public Education and Bystander CPR

Strength

moderate

Relationship

Public CPR training and AED awareness strengthen the first three links of the Chain of Survival at the community level

To

ACLS Rhythms and Drug Therapy

From

Epinephrine Administration

Strength

strong

Relationship

Epinephrine 1 mg IV/IO every 3-5 minutes is standard drug therapy in all arrests; dose and concentration are critical

To

Shockable Rhythms: VF and Pulseless VT

From

Amiodarone

Strength

strong

Relationship

Amiodarone 300 mg first, 150 mg second dose is used for VF/pVT refractory to defibrillation