Monday, October 18, 2010

The 2010 ACLS guidelines are here!

The entire document is available as free full text and can be found here.

For a quick overview of the changes you can read the executive summary. I may have more to say about the guidelines as I work through the entire document but some highlights are here (comments apply only to adult patients):

The time honored ABC sequence for basic life support is out. CAB is in.

Forget “look, listen and feel.” If someone collapses and isn't breathing (or is only gasping) call 911 and start pumping.

Compression only CPR moves from being an option to the preferred method for lay rescuers.

Depth of compression changes from 1.5-2 inches to 2 inches or greater.

Quantitative waveform capnography for confirmation and maintenance of ETT placement now has a Class I recommendation.

Routine use or cricoid pressure is out.

For monomorphic, regular, stable wide complex tachycardias of unknown etiology you can now use adenosine.

For unstable bradycardia after failure of atropine chronotrope infusion (by which I assume they mean a dopamine drip) is equal to transcutaneous pacing.

The post resuscitation bundle, including a hypothermia protocol and early PCI, even while the patient is comatose, is recommended.

Triage of stroke patients to a designated center is a Class I recommendation.

Admission to a dedicated stroke unit is a Class I recommendation.

The extended time window for TPA administration for ischemic stroke is recognized, with slightly different exclusion criteria for the extended window.

There's a lot to talk about here, and I'll probably be posting additional details later.

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