2010 ACLS Guidelines

AHA 2010 guideline updates

Complete guidelines available at www.heart.org/eccguidelines

Local copy of updates here

Continued emphasis on high quality CRP with minimal interruptions

Change sequence from "ABC" to "CAB"

o Chest compressions first then ventilations after first cycle

"Look, listen, Feel" removed from the algorithm

Pulse checks deemphasises

No difference between witnessed and unwitnessed arrest protocols

Non-trained bystanders should provide "Hands-only" CPR

Compression rate at least 100/minute

Compression depth of at least 5cm (adults)

Complete chest recoil after each compression

Minimise interruptions in compressions

Avoid excessive ventilation

Emphasis on team approach with multiple simultaneous interventions

Electrical therapy

Lay people encouraged to use an AED, even without training

Initial biphasic shock for AF is 150J

Adults with stable monomorphic VT - trial synchronised 100J

ACLS

Routine cricoid pressure not recommended

Use continuous capnography if intubated

Emphasis on high quality CPR

Atropine no longer used in PEA/Asystole

Adenosine is recommended in stable, undifferentiated, regular monomorphic wide

complex tachycardia

Trial of chronotropic drugs before pacing suggested for unstable bradycardia

Post cardiac arrest

Therapeutic hypothermia and percutaneous coronary interventions encouraged

Pos arrest O2 titrated to keep SaO2 >94%