ACLS 2010

The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.

PLATO

ACLSBrief Overview & 2010 AHA ECC Guidelines

Dr. Shahab Riaz Department of Cardiology

Brief Overview & 2010 AHA ECC Guidelines

Dr. Shahab Riaz Department of Cardiology

WHAT IS ACLS?

Advanced Cardiac Life Support

An extension of BLS (Basic Life Support)

Guidelines update every 5 years

BLS (Basic Life Support)

ACLS

More specialized

In field or in hospital

Monitor, Defib., Cardioversion, Proper Airway,

I/V Access, Drugs

Continuing CPR.

2010 AHA Guidelines for CPR and ECC, published in Circulation: Journal of the American Heart Association

CARIAC ARREST 2005 vs 2010

TACHYARRYTHMIAS 2005 vs 2010

BRADYARRYTHMIAS 2005 vs 2010

HIGH QUALITY CPR

Adequate Rate; 100/min ---- Music/Songs Adequate Depth:

Adults & Children; 2 inches

Infants; 1 ½ inches Allow complete chest recoil Minimizing Interruptions Avoid excessive ventilation Multiple rescuers -----Rotate task every 2 mins

SUMMARY OF UPDATES; ACLS 2010ABC CAB

Neonatal arrests mostly asphyxia ABC retained unless known cardiac aetiology, 3:1

Untrained/Lay people Hand-only CPR

CPR Depth from 1 ½ to 2 inches minimum 2 inches

Minimum pauses in CPR even if needed

Cont……

Learning/practising regularly, teamwork techniques

Professional rescuers quantitative waveform capnography confirm intubation and CPR quality

Therapeutic hypothermia/cooling after resuscitation from arrest

Atropine deleted from PEA & Asystole management

To reduce time to defib. AED training should not be limited

Cont……

Look, Listen and Feel removed from BLS Algorithm

Continued de-emphasis on pulse check for health care providers and no pulse check for lay persons

Chronotropic drug infusions alternative to pacing in symptomatic and unstable bradycardia.

Adenosine safe and potentially effective therapy in the initial management of stable undifferentiated regular monomorphic wide-complex tachycardia.