AHA recommendation changes by year

For current guidlines see ACLS (Main)

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
  • 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)


See Also