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
  • Lidocaine is removed for unstable VTach
• New section on post arrest care
• No tPA for HTN 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 w/ 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 w/ 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 w/o touching
  • When possible leave 3cm between electrodes
  • Adult size for >10kg; infant size for <10kg
• Hypotension is defined as sys BP:
  • <60 (0 to 28 days)
  • <70 (1mo - 12mo)
  • <70 + (2 X age in yr) (1-10yr)
  • <90 (≥10yr)

See Also

• ACLS (Main)
• PALS (Main)