2011 ACLS Information
By Lifesaver Education
Every five years ACLS guidelines are reviewed and protocols or procedures are modified based upon the data collected in the previous five years by The American Heart Association and The International Liaison Committee of Resuscitation. In late 2010 new guidlines for 2011 were announced and are as follows:
A-B-C to C-A-B:
The standard A-B-C (Airway, Breathing, Circulation) has been changed to the C-A-B approach (Circulation, Airway, Breathing). This puts emphasis on circulation and maintaining blood flow in the case of life threatening heart malfunction or arrhythmia.
Chest Compression Changes:
Instead of the previously recommended depression of the sternum to 1 ½ to 2 inches, it is now suggested that a depression of at least 2 inches should be performed and should include a complete recoil of the chest. Compressions should be performed at a rate of at least 100 beats per minutes, rather than the previously recommended 'about' 100 beats per minute, to sustain adequate blood flow to the heart. It has also been suggested that it should take no longer than ten seconds to check for a pulse before initiating compressions.
Quantitative Waveform Capnography Recommendation:
Use of quantitative waveform capnography is recommended for confirmation and monitoring of endotracheal tube placement. Quantitative waveform capnography can monitor the security and stability of the placement while also gauging the effectiveness of chest compressions.
New Med Protocols:
Four new medication changes have be en implemented for 2011. Firstly, atropine is no longer recommended for routine use in the management of pulseless electrical activity (PEA) or asystole. Secondly, adenosine is indicated for the treatment of undifferentiated wide-complex tachycardia when the rhythm is regular and the QRS complex is monomorphic. Thirdly, IV chronotropic medications can be an effective alternative to externally pacing a patient exhibiting symptomatic or unstable bradycardia. And, finally, supplementing the oxygen for uncomplicated acute coronary syndromes is no longer indicated and should only be used when a patient's oxyhemoglobin saturation is less than or equal to 94 percent.
Emergency Care Priority:
So as not to delay or interrupt chest compressions or the use of defibrillators, establishing advanced airways, vascular access and introducing medications no longer take precedence over high quality CPR and access to defibrillation.
Post Cardiac Arrest Care:
The newest guidelines for PCAC include a structured care system offering therapeutic hypothermia treatments and percutaneous coronary interventions such as revascularization and angiography.
New Stroke Guidlines:
The window of time for use of thrombolytics (rTPA) remains at within three hours of onset of stroke symptoms, but in selected patients can be extended to be within four and one-half hours after symptom onset. Also, the prehospital treatment of blood pressure has been de-emphasized.
Keep yourself informed about the latest ACLS guidelines by signing up for local Los Angeles CPR classes or an online BLS course.
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