advanced life support 2021

Attempt confirmation of tracheal intubation by ventilating through the tracheal tube. Hospitals should use a track and trigger early warning score system for the early identification of patients who are critically ill or at risk of clinical deterioration. Obtain neurological assessment and tests by a specialist. When you are unable to open airway using head tilt-chin lift or jaw thrust maneuvers. Continue neurological exams (non-Contrast CT scan), and monitor hemodynamics. Follow current European Society of Cardiology (ESC) guidelines for the diagnosis and management of syncope. Our regular newsletter contains updates on all things resuscitation, information about campaigns for CPR education and opportunities to purchase event tickets, manuals, and other RCUK merchandise. Closed on Sundays. Department of Family Medicine and Community Health. The course consists of pre and post-course tests, lectures, case . National Survey: How Do We Approach the Patient at Risk of Clinical Deterioration outside the ICU in the Spanish Context? Kaylene WeirCox, MD, FACS. Laryngoscope blades (average adult size): MAC 3 or 4, Miller 2 or 3. Monitor for changes in the hemodynamic status of the patient. If treatment with atropine is ineffective, consider second line drugs. Basic Life Support in Obstetrics (BLSO) is a course that has been adapted from the ALSO content to meet the unique needs of paramedics, EMTs, medical students and nursing students. BACKGROUND The Advanced Life Support in Obstetrics (ALSO) program helps pregnancy care providers learn the information and skills necessary to deal with urgent and emergent conditions that arise during pregnancy and delivery by using mannequins, mnemonics, and evidence-based approaches. All ACLS course options teach the same AHA science-based skills and result in the same AHA ACLS Course Completion Card. Please enable it to take advantage of the complete set of features! PMC The expert consensus is that a high success rate is over 95% within two attempts at intubation. Find a job here as an engineer, experimental physicist, physics faculty, postdoctoral . Take your time to review each section. The American Academy of Family Physicians is approved as a provider of continuing nursing education by the Kansas State Board of Nursing. ][Faint pulse is felt approximately 35 times a minute.]. Job Description. Resuscitation. Careful not to cause trauma to nasal mucosa (results in bleeding). Initiate transcutaneous pacing until transvenous pacing can be initiated. Guidelines 2021 are based on the International Liaison Committee on Resuscitation 2020 Consensus on Science and Treatment Recommendations for Advanced Life Support and the European Resuscitation Council Guidelines for Resuscitation (2021) Advanced Life Support. Do not use POCUS for assessing contractility of the myocardium as a sole indicator for terminating CPR. . 3 Courses. We suggest healthcare systems ensure staff with a duty to provide ALS receive accredited RCUK ALS provider training (. 2022 Oct 20;9(1):e802. Give a shock as early as possible when appropriate. These include primary survey, secondary survey, advanced airways, myocardial infarction, cardiac arrest, tachycardias, bradycardias, and stroke. : adenosine, verapamil, cardizem, and digoxin. Amiodarone or lidocaine, that is the question - Pharmacological therapy of refractory ventricular fibrillation associated with Brugada syndrome. There are two important principles when evaluating the airway and breathing. 2022 Oct 6;12:100310. doi: 10.1016/j.resplu.2022.100310. Epub 2014 Nov 11. ALSO International has been utilized in 62 countries and educated thousands of healthcare providers around the world. Used to treat Atrial Fibrillation, Atrial Flutter, Atrial Tach, and Symptomatic VT. 2020 -2025 Guidelines and Standards ACLS Advanced Cardiac Life Support Provider Handbook By Dr. 1 ACLS - Cervical Spine Injury?If the provider evaluates the patient to have an obstructed airway, intervention should take place. Once a tracheal tube or a supraglottic airway (SGA) has been inserted, ventilate the lungs at a rate of 10 min. LMAs are contraindicated in patients with GERD, full stomachs, and pregnant women. The combitube provides ventilatory access irregardless of tracheal or esophageal intubation. MEDICAL SCHOOL. The https:// ensures that you are connecting to the Perkins GD, Jacobs IG, Nadkarni VM, Berg RA, Bhanji F, Biarent D, Bossaert LL, Brett SJ, Chamberlain D, de Caen AR, Deakin CD, Finn JC, Grsner JT, Hazinski MF, Iwami T, Koster RW, Lim SH, Ma MH, McNally BF, Morley PT, Morrison LJ, Monsieurs KG, Montgomery W, Nichol G, Okada K, Ong ME, Travers AH, Nolan JP; Utstein Collaborators. For patients with LVEF < 40%consider the smallest dose of beta-blocker to achieve a heart rate less than 110 min. ABLS Live Positive pressure ventilation is generally kept under 20 CmH2O to prevent inflation of the stomach. ][After the AED analyzes the patient a shock is recommended.]. Pediatric Advanced Life Support (PALS) guidelines are updated every five years and the new 2020 guidelines were issued recently. official website and that any information you provide is encrypted This is why Advanced Trauma Life Support (ATLS) provides a method for immediate management of injured patients. Advanced Life Support. Approved for 1 day grant in either anaesthetics or emergency medicineRACGP: 422 - Advanced Life Support Level 1 - Immediate Life Support 40 points QI&CPD, BLS, Anaesthetics, Grant eligible. ACLS teaches healthcare professionals advanced interventional protocols and algorithms for the treatment of cardiopulmonary emergencies. *Red Dress DHHS, Go Red AHA ; National Wear Red Day is a registered trademark. Emphasis on preventing cardiac arrest, early and continuous high-quality CPR, integration of BLS into ACLS and importance of high-performing teams, Hands-on team dynamics classroom activities, Video-based course with real world scenarios. Generally accepted treatments: MONA: Morphine, Oxygen, Nitrates, and Aspirin, first line Rx is: Adenosine 1st dose: 6mg IV then 2nd and 3rd doses: 12mg IV, Other Rx options include: Diltiazem and Beta blockers, Rx options include: Diltiazem and Beta blockers. ACLS is geared towards healthcare professionals who either direct or participate in the management of cardiopulmonary arrest or other cardiovascular emergencies or personnel in emergency response. A range of defibrillation energy levels have been recommended by manufacturers and previous guidelines, ranging from 120-360 J. About Us. Advanced Life Support in Obstetrics (ALSO) | BCM Autism Obesity Substance Abuse View All Clinical Trials General Inquiries Call today to schedule an appointment or fill out an online request form. Australian Resuscitation Council, Advanced Life Support Courses provide CPD points for the following colleges View our courses 2022 dates available now. If the patient requiring continued ventilatory support. (if lead II is asystolic, confirm rhythm in leads avL and III.). Hospitals should have a resuscitation team that immediately responds to in hospital cardiac arrest (IHCA). Never quite there? 1-year nationally recognised certificate. Basic life support continues during and overlaps with ALS interventions. The course content is presented in the form of self-directed learning content, probes, and Cognitive Assessment Activities. Tracheal cuff of the ETT is then inflated. If an advanced airway is required, only rescuers with a high tracheal intubation success rate should use tracheal intubation. coronary angiography and percutaneous coronary intervention (PCI), pulmonary thrombectomy for massive pulmonary embolism, rewarming after hypothermic cardiac arrest) in settings in which it can be implemented. 2015 Nov;96:328-40. doi: 10.1016/j.resuscitation.2014.11.002. Unable to load your collection due to an error, Unable to load your delegates due to an error. Details of the guidelines development process can be found in theResuscitation Council UK, RCUK supports shared decision making and advanced care planning which integrates resuscitation decisions with emergency care treatment plans to increase clarity of treatment goals and also prevent inadvertent deprivation of other indicated treatments, besides CPR. Consider extracorporeal CPR (eCPR) as a rescue therapy for selected patients with cardiac arrest when conventional ALS measures are failing and to facilitate specic interventions (e.g. Avoid use in patients with an active gag reflex. Coordinator Online Community systematic reviews with grading of the certainty of evidence and strength of recommendations. All hospital staff should be able to rapidly recognise cardiac arrest, call for help, start CPR and defibrillate (attach an AED and follow the AED prompts, or use a manual defibrillator). European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. AIM encourages state and hospital quality improvement (QI) teams to align on the national, state, and hospital level in an effort to improve overall maternal health outcomes in the United States. ACLS teaches healthcare professionals advanced interventional protocols and algorithms for the treatment of cardiopulmonary emergencies. Continue CPR while a defibrillator is retrieved, and pads applied. Saturday: 9 a.m. - 5 p.m. CT The guideline that came out in October of 2020, published in Circulation, was right in the middle of COVID. Soar J, Berg KM, Andersen LW, Bttiger BW, Cacciola S, Callaway CW, Couper K, Cronberg T, D'Arrigo S, Deakin CD, Donnino MW, Drennan IR, Granfeldt A, Hoedemaekers CWE, Holmberg MJ, Hsu CH, Kamps M, Musiol S, Nation KJ, Neumar RW, Nicholson T, O'Neil BJ, Otto Q, de Paiva EF, Parr MJA, Reynolds JC, Sandroni C, Scholefield BR, Skrifvars MB, Wang TL, Wetsch WA, Yeung J, Morley PT, Morrison LJ, Welsford M, Hazinski MF, Nolan JP; Adult Advanced Life Support Collaborators. Hospital staff should use structured communication tools to ensure effective handover of information. Certify today and start saving lives. Eligibility to participate is limited to doctors in countries where the program has been . Use data-driven, performance-focused debriefing of rescuers to improve CPR quality and patient outcomes. Learners. 483 Reviews. the online pediatric advanced life support instructor bridge is designed to allow instructors currently certified with approved, equivalent training organizations to become certified as american red cross pediatric advanced life support instructors.candidates must meet course prerequisites and upload qualifying credential to complete the training coronary angiography and percutaneous coronary intervention (PCI), pulmonary thrombectomy for massive pulmonary embolism, rewarming after hypothermic cardiac arrest) in settings in which it can be implemented. Medicine. Tufts CEA registry and NHS EED databases from database inception to 2021 or 2015 for NHS EED. Phone: 612-624-2622. The Advanced Life Support in Obstetrics (ALSO) program contains AIM supported educational content, specifically related to obstetric hemorrhage and severe hypertension in pregnancy and more. Wyckoff M, Singletary EM, Soar J, et al. Emergency medical systems (EMS) should monitor staff exposure to resuscitation and low exposure should be addressed to increase EMS team experience in resuscitation. the involvement of stakeholders from around the world including members of the public and cardiac arrest survivors. HHS Vulnerability Disclosure, Help Circulation. 5 The study protocol does not mandate or prohibit any specific concomitant care . Lidocaine 100 mg IV (IO) may be used as an alternative if amiodarone is not available or a local decision has been made to use lidocaine instead of amiodarone. First Step to using AED is turning on the device. Prevents leak through the nose and mouth. ALS procedure includes invasive interventions, such as endotracheal intubation for airway management, and intravenous catheters for drug and fluid delivery. After completing the online portion, students will attend a structured, Instructor-led hands-on session that focuses on meaningful skills practice, debriefing, team dynamics training, megacode cases, discussions of local protocols and skills testing. Upon successful completion of the course, students receive a course completion card, valid for two years. Oxygen by NC, ECG, and IV access are already established. oxygenation saturation with pulse oximeter, 8-10 breaths per minute (1 breath every 6-8 seconds). An initialsynchronised shock at maximum defibrillator output rather than an escalating approach is a reasonable strategy based on currentdata. Attempt intravenous (IV) access first to enable drug delivery in adults in cardiac arrest. These European Resuscitation Council Advanced Life Support guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. Place pads and electrodes in correct position to assure an appropriate ECG reading. Procainamide 20 to 50 mg/min IV until arrhythmia resolves, hypotension occurs, there is >50% increase in QRS duration, or the max dose of 17 mg/kg is reached (Maintenance infusion: 1 to 4 mg/min). 516 Delaware St. Helps secure placement. Resusc Plus. This ALSO Provider Course - live portion has been approved to meet ABOG Improvement in Medical Practice requirements until 12/31/2023. If an advanced airway is required, only rescuers with a high tracheal intubation success rate should use tracheal intubation. Minimise the risk of fire by taking off any oxygen mask or nasal cannulae and place them at least 1 m away from the patients chest. 2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. (Drug therapy, Electrical therapy, Pacing, etc.). For bradycardia caused by inferior myocardial infarction, cardiac transplant or spinal cord injury, consider giving aminophylline (100200 mg slow intravenous injection). In patients with an implantable device, place the pad > 8 cm away from the device, or use an alternative pad position. Procainamide and sotalol should be avoided in patients with prolonged QT. The 'ALSO' course was developed in 1991 at Wisconsin University in United States of America and . Antero-lateral pad position is the position of choice for initial pad placement. More than 20 000 infants and children have a cardiac arrest per year in the United States.1-4 In 2015, emergency medical service-documented out-of-hospital cardiac arrest (OHCA) occurred in more than 7000 infants and children.4Approximately 11.4% of pediatric OHCA patients survived to hospital discharge, but outcomes varied by age, with survival rates of 17.1% in adolescents, 13.2% in . Some possible changes are apnea (cessation of breathing), irregular breathing patterns, or poor inspiratory volumes. Email: fmch@umn.edu. * $20-$21/Hr. Advance the LMA till the cuff lies in the pharynx. HeartCode ACLS uses a personalized adaptive algorithm that sets students on the most efficient path to ACLS mastery. Assure the patient is sedated and comfortable during pacer delivery. The hospital resuscitation team should include team members who have completed an accredited RCUK. Young adults presenting with characteristic symptoms of arrhythmic syncope should have a specialist cardiology assessment, which should include an electrocardiogram (ECG) and in most cases echocardiography and an exercise test. Treat causes (atropine 0.5-1mg IV may be used if vagal mechanism is suspected). Use direct or video laryngoscopy for tracheal intubation according to local protocols and rescuer experience. 2022 American Heart Association, Inc. All rights reserved. Downloads Adult Advanced Life Support Algorithm 2021 36.84 KB Adult in hospital resuscitation Algorithm 2021 39.36 KB Tachycardia Algorithm 2021 42.74 KB Bradycardia Algorithm 2021 35.97 KB RCUK Quick Reference Handbook 1.71 MB 2021 Resuscitation Guidelines Quality Standards for CPR Additional guidance ReSPECT iResus Publications 2015 Sep 29;132(13):1286-300. doi: 10.1161/CIR.0000000000000144. Office of Research Support Overview. Refer to the ERC guidelines publications for supporting reference material. When the patient has a high risk for aspiration (provide an ETT or Combitube). Our courses will provide you with the skills for managing the deteriorating patient and cardiac arrest including airway management, basic life support, safe defibrillation and life threatening arrhythmias. Advanced Cardiovascular Life Support (ACLS) is available in two different training methods blended learning and classroom training. . If the jaw-thrust proves unsuccessful in opening the patients airway attempt an oropharangeal or nasopharangeal airway. Hospitals should use a standard Cardiac Arrest Call telephone number (2222). doi: 10.1161/CIR.0000000000000731. Soar J, Bttiger BW, Carli P, Couper K, Deakin CD, Djrv T, Lott C, Olasveengen T, Paal P, Pellis T, Perkins GD, Sandroni C, Nolan JP. Symptoms such as syncope (especially during exercise, while sitting or supine), palpitations, dizziness and sudden shortness of breath that are consistent with an arrhythmia should be investigated. Epub 2021 Oct 22. Consider giving glucagon if beta-blockers or calcium channel blockers are a potential cause of the bradycardia. If the patient is attempting spontaneous breaths without success, there may be noticeable effort of intercostal muscles, diaphram, or other accessory muscles without significant chest rise/expansion. If requested before 2 p.m. you will receive a response today. SE. If neither technique works, attempt an advanced airway using inline stabilization. This page is a free resource to the public to demonstrate these AHA algorithms. No accessible blended learning version at this time. ][Have student perform prehospital stroke assessment. With the new adaptive learning format, the timing for completing the online portion of HeartCode ACLS can vary depending on the students level of experience. Successfully complete this free online course on ACLS and apply for a certificate to become globally accredited. Adult advanced life support (ALS) includes the advanced interventions that follow basic life support (BLS) and use of an automated external debrillator (AED). Consider mechanical chest compressions only if high-quality manual chest compression is not practical or compromises provider safety. Epub 2020 Oct 21. There is no evidence to express a preference for a policy of primarily transporting via ambulance (using bypass protocols) or one of secondary inter-hospital transfer. Assess patients rhythm and treat with appropriate ACLS algorithm. In the past, this regulatory oversight has been based on the publication of minimum recommended equipment standards, including previous versions of this document. myocardial ischaemia may present with chest pain (angina) or may occur without pain as an isolated finding on the 12-lead ECG (silent ischaemia). It is a standardised national course teaching evidence-based resuscitation guidelines and skills to healthcare professionals in the United Kingdom. It is a standardised European course teaching evidence-based resuscitation guidelines and skills to healthcare professionals. Bethesda, MD 20894, Web Policies anterior- posterior). Which feature would the healthcare provider interpret as indicating atrial fibrillation? Determine if the patient is stable or unstable. CPD time credit conformation. Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. The ABOG MOC standards now allow participation in ABOG-approved Simulation Courses to meet the annual Improvement in Medical Practice (Part IV) MOC requirement. Determine if the patient is Stable or Unstable. 1 for these erc guidelines the ilcor recommendations were supplemented by focused literature reviews undertaken by the erc als writing group for those topics not reviewed in the 2020 Advanced cardiac life support (ACLS) is the fourth link in the 'chain of survival'. This may include a critical care outreach service and/or emergency team (e.g. HeartCode PALS Online is a self-directed, comprehensive eLearning program that uses adaptive learning technology to allow learners to acquire and demonstrate Pediatric Advanced Life Support skills using a personalized learning path that adapts in real time to a learner's performance. Mark which tube should be used for ventilation. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. 2021 Dec;169:76-77. doi: 10.1016/j.resuscitation.2021.10.022. Instructor Online Community. Obtain IV/IO Access. Second, is there possible injury or trauma that would change the providers method of treating an obstructed airway or inefficient breathing. SupraVentricular Tachycardia (SVT) with Aberrancy: Atrial Fibrillation with Wolff Parkinson White (delta wave): Ventricular Tachycardia (VT) monomorphic: Ventricular Tachycardia (VT) polymorphic: Pulseless Ventricular Tachycardia / Ventricular Fibrillation (Refractory): Initiated treatment within 10 min of arrival to the ER: Initiated treatment within 25 min of arrival to the ER: 1) You are shopping at a grocery store and an elderly lady in the produce section suddenly grimaces, grabs her chest, and falls to the floor. Copyright 2021. and the victim are safe. Acute Med Surg. If bradycardia is accompanied by life-threatening adverse signs, give atropine 500 mcg IV (IO) and, if necessary, repeat every 35 minutes to a total of 3 mg. Transcutaneous Pacemaker (External Pacemaker):Used to treat unstable bradycardias not responding to drug therapy. The ALS course provides a standardised approach to cardiopulmonary resuscitation in adults. Circulation. Consider CPR for 60-90 minutes after administration of thrombolytic drugs. Aim for less than a 5 second interruption in chest compression for tracheal intubation. Start at O mA and work energy level up until you have capture (heart pulsation). When adrenaline is used, it should be used as soon as possible when the cardiac arrest rhythm is non-shockable, and after 3 defibrillation attempts for a shockable cardiac arrest rhythm. Brain Injury?The breathing center that controls respirations is found within the pons and medulla of the brain stem. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest: A Statement for Healthcare Professionals From a Task Force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. Conscious patients require anaesthesia or sedation, before attempting synchronised cardioversion. Requires proper lead/pad placement to monitor ECG. Latest Announcements Initially provide rescue breaths using an ambu bag and a mask at full flow oxygen. Identification of individuals with inherited conditions and screening of family members can help prevent deaths in young people with inherited heart disorders. The AHA offers options for how you can purchase ACLS. Advanced Burn Life Support (ABLS) programs, ABLS Live and ABLS Now, provide knowledge for immediate care of the burn patient up to the first 24 hours post-injury. This ALS section includes the prevention and treatment of both in- hospital Copyright 2014 - 2022 below the armpit. Hospitals should empower all staff to call for help when they identify a patient at risk of physiological deterioration. For ventricular tachycardia with a pulse: Use energy levels of 120-150 J for the initial shock. Monitors (ECG, BP cuff, pulse oximeter, et CO2 monitor), Initiate therapy of ACLS algorithm corresponding with the identified heart rhythm. High-quality chest compressions with minimal interruption and early defibrillation remain priorities. medical emergency team, rapid response team). Hospitals should have a clear policy for the clinical response to abnormal vital signs and critical illness. 2022 Oct 3;19(19):12627. doi: 10.3390/ijerph191912627. ABLS programs also support emergency and mass casualty preparedness focusing on triage, burn survivability, patient transportation, and patient treatment. Both cuffs must be inflated to appropriately ventilate a patient in the case of esophageal intubation. We have a separate page for additional information on the anatomy of the human heart. sharing sensitive information, make sure youre on a federal during cardiac catheterisation or in a high-dependency area. The European Resuscitation Council (ERC) has developed its Advanced Life Support (ALS) provider course, based on ERC guidelines. Algorithms for Advanced Cardiac Life Support Version control: Our ACLS, PALS & BLS courses follow 2020 American Heart Association Guidelines for CPR and ECC. European Resuscitation Council Guidelines 2021: Adult advanced life support Authors Jasmeet Soar 1 , Bernd W Bttiger 2 , Pierre Carli 3 , Keith Couper 4 , Charles D Deakin 5 , Therese Djrv 6 , Carsten Lott 7 , Theresa Olasveengen 8 , Peter Paal 9 , Tommaso Pellis 10 , Gavin D Perkins 11 , Claudio Sandroni 12 , Jerry P Nolan 13 Affiliations doi: 10.1002/ams2.802. Allows for positive pressure ventilation. In the absence of any clear evidence for the optimal initial and subsequent energy levels, any energy level within this range is acceptable for the initial shock, followed by a fixed or escalating strategy up to maximum output of the defibrillator. 3) You enter your friends house to find their elderly grandmother staring at the wall and leaning to their side. Consider stepwise increases if the first shock fails to achieve sinus rhythm. The approach is systematic and concise as well as safe and reliable. eCollection 2022 Jan-Dec. Pocock H, Deakin CD, Lall R, Michelet F, Contreras A, Ainsworth-Smith M, King P, Devrell A, Smith DE, Perkins GD. government site. You can take a full classroom course, take a blended learning course (HeartCode ACLS + a hands-on skills session training), or purchase additional course materials. All courses are held at The Prince Charles Hospital, Brisbane. Best practice is to lube before insertion. Give amiodarone 300 mg IV (IO) for adult patients in cardiac arrest who are in VF/pVT after three shocks have been administered. Consider intraosseous (IO) access if attempts at IV access are unsuccessful or IV access is not feasible. ALS: 2 Day Course (Advanced Life Support) Course, Adult Advanced Life Support Algorithm 2021, Adult in hospital resuscitation Algorithm 2021, Application for permission to reproduce RCUK materials, Membership: Frequently Asked Questions (FAQs). Epub 2021 Jun 21. Clinical practice guidelines on adult advanced life support (ALS) were published in April 2021 by the European Resuscitation Council (ERC) in Resuscitation. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators .

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