The American Heart Association releases new ACLS guidelines every 5 years based on research and data collected since the last guideline revision. This scientific research is compiled from resuscitation experts around the world, and incorporates the latest techniques and life support strategies. The guidelines mandated by the AHA serve as the foundation for life support training worldwide and are used by major organizations.
The most recent ACLS Guidelines were released in 2010, and will remain in effect until 2015. All ACLS certification courses abide by the 2010 AHA material, and no new guidelines will be issued until 2015.
If you trained with the older guidelines, you are not required to re-take an ACLS course until your 2-year certification expires. ACLS provider cards are valid for 2 years after their issue, even if the AHA guidelines have been revised.
Here is a summary of the 2010 ACLS Guideline Changes:
Chest Compression Changes
The old ABC (airway, breathing, circulation) method has been changed to a new CAB (circulation, airway, breathing) method. This approach ensures that chest compressions are not delayed or interrupted.
Chest compressions now take priority over advanced airway use and IV use because studies have shown that efficient CPR increases survival more than any other method. However, this doesn’t apply to hospital situations in emergency departments where intubation can begin straight away.
ACLS Pharmaceutical Changes
Atropine has been shown to be ineffective during asystole and PEA, and is no longer recommended for either case.
For acute coronary syndromes, oxygen supplementation is no longer recommended and should only be used if arterial oxyhemoglobin saturation is less than or equal to 94%.
Adenosine is the recommended treatment for stable tachycardia with a regular heart rhythm.
For unstable bradycardia, IV agents are now recommended over external pacing.
New Recommended Stroke Care
The use of rTPA (thrombolytics) during onset of stroke symptoms has been extended from 3 hours to 4 ½ hours for selected patients who meet certain criteria (for other patients, it remains at 3 hours).
During pre-hospital care, blood pressure treatment is no longer emphasized.
Post-Cardiac Arrest Care
A section for Post-Cardiac Arrest Care has been added to the ACLS provider manual, and the section focuses on an integrated approach for after-care. For example, since seizures are common after suffering from cardiac arrest, electroencephalograms should now be performed to diagnose and monitor seizures.