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3c. 2015 BLS Guideline Changes, Advanced Cardiac Life Support (ACLS) (2020) - OLD

The third lesson of chapter 3 covers the most recent 2015 BLS guideline changes. The ILCOR updated its ECC guidelines by strengthening some of the recommendations made in 2010. This segment provides a summary of those guideline changes. "In 2015, the ILCOR update on its ECC guidelines strengthened some of the recommendations made in 2010. Here is a summary of the changes made to 2015 BLS guidelines: The 2010 sequence change from Airway, Breathing, Compressions (or ABC) to Compressions, Airway, Breathing (or CAB) remains in the 2015 update. The early initiation of chest compressions resulted in improved outcomes. Previously, as a rescuer or a provider, you may have been faced with the choice of leaving the individual to activate EMS. Nowadays, you are more likely to have a cell phone, often with speakerphone capabilities. The 2015 BLS guidelines encourage you to use a speakerphone or other hands-free device, allowing yourself to continue rendering aid while communicating with the EMS dispatcher. The 2015 update also suggests that if you’re an untrained rescuer or provider, you should initiate hands-only CPR under the direction of the EMS dispatcher as soon as the individual is identified as unresponsive. Meanwhile, if you’re a trained rescuer or provider, you should continue to provide CPR with rescue breaths. In situations where unresponsiveness is thought to be from a narcotic overdose, as a trained BLS rescuer, you may administer naloxone via the intranasal or intramuscular route, if the drug is available. For individuals without a pulse, administer the drug after CPR is initiated. In cardiac arrest, use the defibrillator as soon as possible and resume chest compressions as soon as a shock is delivered. Biphasic defibrillators are more effective in terminating life-threatening rhythms and are preferred to older monophasic defibrillators. Energy settings of defibrillators vary by manufacturer, so you should follow the device-specific guidelines. For cardiac arrest that is suspected to be caused by coronary artery blockage, perform angiography emergently. Standard dose of epinephrine, that is 1mg every 3 to 5 minutes, is the preferred vasopressor. High dose epinephrine and vasopressin have not been shown to be more effective, and therefore, are not recommended. Maintain constant target temperature between 32 to 36 degrees C for at least 24 hours in the hospital environment. Routine cooling of individuals in the prehospital environment is not recommended. The 2015 guidelines also emphasize on the importance of high-quality chest compressions, with enhanced recommendations for maximum rates and depths. To perform high-quality chest compressions, keep the following in mind: Chest compressions should be 100 to 120 per minute because compressions faster than 120 per minute may not allow for a cardiac refill and reduce perfusion. Additionally, you should deliver compressions should be to adults at a depth between 2 to 2.4 inches, which is 5 to 6 cm, because compressions at greater depths may result in injury to vital organs without increasing odds of survival. For children (that is less than one year old), deliver at a depth between 1.5 to 3 inches, which is 4 to 5 cm. Be sure to allow for full chest recoil between compressions to promote cardiac filling. Because it is difficult to accurately judge the quality of chest compressions, an audiovisual feedback device may be used to optimize the delivery of CPR during resuscitation. Interruptions of chest compressions, including pre- and post-AED shocks should be as short as possible. Compression to ventilation ratio remains 30:2 for individuals without an advanced airway in place. For individuals with an advanced airway in place, you should provide uninterrupted chest compressions with ventilation at a rate of one every six seconds. For further details or an in-depth review of 2015 guideline change, please refer to the ILCOR’s executive summary document." Need to be certified or recertified in ACLS visit https://disquefoundation.org/acls-cou... ************************************** Follow us on social media! Facebook:   / disquefoundation   Twitter:   / disquefndn   Instagram:   / disquefoundation   Pinterest:   / disquefoundation   LinkedIn:   / disque-foundation   Website: https://disquefoundation.org/ To find out more about the Save a Life Initiative and the Disque foundation please visit our site or email us at [email protected] Together, let’s save lives.