5 h and t of acls and cardiac arrest - Reversible causes of cardiac arrest explained

5 H and T of cardiac arrest and ACLS

H and T basic info: Cardiac arrest is the moment before death in which the heart stops working. During resuscitation, one of the team members must be thinking of the H's and T's  of the cardiac arrest simulataneously. This is very important because these are the reversible causes of the cardiac arrest and successful corection of these lead to reversal of the cardiac arrest and saves the life.

These H and T are also called 5H and 5 T of the ACLS. ACLS stands for advanced cardiac life support and it is the main lifesaving resuscitation guideline worldwide.

The Hs and Ts are as follows

  1. Hypoxia
  2. Hypovolemia
  3. Hypo/Hyperkalemia/metabolic
  4. Hypothermia
  5. Hydrogen ions(acidosis)

  6. Thrombosis-cardiac(MI), Pulmonary
  7. Tamponade-cardiac
  8. Toxins
  9. Tension Pneuothorax
  10. Trauma
H and T ACLS
H and T ACLS

How to deal with H and T of cardiac arrest during ACLS

Let deal with all of them one by one:


For Hypoxia providing oxygen is the only solution. 


For management of hypovolemia fluid resuscitation is the key. The patient should immidiately have two (possibly large bore) IV cannula paced and at least one litre of crystalloid (NS) should be infused as fast as possible unless contraindicated. 

Hypo or Hyperkalemia

For manageent of hypo or hyperkalemia, either it should be checked immidiately. Or also calcium gluconate should be infused as it stabilizes membranes and prevents further deteoration in the upcoming

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