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AHA recommendation changes by year
From WikEM
For current guidlines see ACLS (Main)
Contents
ACLS
2010 AHA Recommendation Changes
- Routine use of cricoid pressure is NOT recommended
- Airway adjunct is recommended while performing ventilation
- Pulse/rhythm checks should only occur q2min
- Most critical component is high-quality compressions
- Atropine and cardiac pacing are NOT recommended for asystole/PEA
2011 AHA Recommendation Changes
- Bystandar CPR changes to CAB (Chest compressions, Airway, Breathing), instead of ABCs
- De-emphasize Drugs, Devices, and other Distracters
- Emphasize good CPR
- Atropine is removed for bradycardia
- Use an epinephrine drip or dopamine drip if needed
- Bicarbonate is out removed
- Except for specific toxidromes or renal failure
- Procainamide is first for stable VTach
- Continue to use amiodarone for unstable
- Use Amiodarone for UNSTABLE VTach
- Lidocaine is removed for unstable VTach
- New section on post arrest care
- No tPA for hypertension Emergency BP (>200/110)
- Reduce BP first
- Special sections and algorithms added for 15 special situations (ie. pregnancy, stroke, PE)
PALS
2010 AHA Recommendations
- Use Heimlich for >1yr; back/chest thrusts for <1yr
- Treat shock with initial 20cc/kg bolus
- Repeat boluses up to total of 60 mL/kg; thereafter pressors should be started
- Do not routinely hyperventilate even in cases of head injury
- Provide family with option of being present during resuscitation
- IO is useful as initial vascular access
- Self-Adhering Electrodes
- Use largest size that will fit on child’s chest with out touching
- When possible leave 3cm between electrodes
- Adult size for >10kg; infant size for <10kg
- Hypotensionis defined as sys BP:
- <60 (0 to 28 days)
- <70 (1mo - 12mo)
- <70 + (2 X age in yr) (1-10yr)
- <90 (≥10yr)
