EMS Cardiology - The Hs & Ts

EMS Providers should be familiar with the Hs and Ts of Advanced Cardiac Life Support (ACLS).

The H’s and T’s of ACLS is a mnemonic used to help recall the major contributing factors to Pulseless Arrest including PEA, Asystole, VF, and VT.

These are categories of reversible causes that can contribute to cardiac arrest. Here's a brief overview:

1. The Hs:

- Hypovolemia: Assess and address any significant loss of fluid or blood.

- Hypoxia: Ensure adequate oxygenation and ventilation.

- Hydrogen Ions (acidosis): Correct any acid-base imbalances.

- Hyper/Hypokalemia: Assess and treat abnormal potassium levels.

- Hypoglycemia: Check blood glucose levels and provide glucose if necessary.

- Hypothermia: Prevent or treat hypothermia as appropriate.

2. The Ts:

- Toxins: Identify and manage any toxic exposures or drug overdoses.

- Tamponade: Consider cardiac tamponade and perform pericardiocentesis.

- Tension Pneumothorax: Recognize and treat tension pneumothorax by decompression.

- Thrombosis (Coronary or Pulmonary): Administer appropriate medications and interventions for thrombotic events.

- Trauma: Address any traumatic injuries that may have caused or contributed to the arrest.

Understanding and addressing these potential causes during ACLS can improve the chances of successful resuscitation.

However, it's important to note that decisions and interventions should be guided by local protocols, guidelines, and medical direction.