AHA 2015 Guideline For CPR and ECC: ACLS

Recently, AHA has published a  2015 Updated Guideline for CPR and ECC. Here I will be sharing some updates for ACLS part.

In a nutshell, there are no major changes compared to the last (2010) guideline.

During CPR

  • Main changes are in CPR compression rate, depth and ventilation rate.
  • Manual compression without any adjunctive device is still preferred over the use of devices eg ITC.

During resuscitation

  • Vasopressin is removed. Early epinephrine is recommended in non-shockable rhythm..
  • Use of ETCO2 as 1 of the factors to discontinue resus efforts.

Post-cardiac arrest

  • Lidocaine and BB should not be used routinely after ROSC.
  • EMERGENT angiography for those suspected to have cardiac ischemia .
  • Temperature range for TTM is widened.
  • Wait for AT LEAST 72 hours before accessing patient for poor neurological outcome, regardless of whether they receive TTM or not.

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For those who do not know impedance threshold device, please watch this:

Compression-decompression CPR using suction device placed on chest


** One thing that I have missed

  • If supplemental O2 is available, the maximal oxygen should be provided to the patients receiving CPR.
  • Unlike in STEMI or post ROSC in which hyperoxia maybe detrimental, CPR is a low flow state. O2 demand is always higher during a cardiac arrest.
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