AMERICAN HEART

ACLS
2010
ASSOCIATION

Health Care Provider*

PUSH HARD AND PUSH FAST
At least 100 COMPRESSIONS / MINUTE*
Allow the chest to recoil -- equal compression and relaxation times
<10 seconds for pulse checks or rescue breaths
Compression Depth*
Adults 2
Child/Infant 1/3 depth of chest

Avoid excessive ventilations

1.5" infant

2" child

 A-B-C changed to C-A-B*

Critical element is chest compressions
Delay in A-B
Avoidance of A & B

Early defib
If alone--call and retrieve AED
Exception asphyxial arrest

 Cricoid pressure not recommended

Advanced airway = 1 every 6-8 seconds

Adult: 1 every 5-6

Peds: 1 every 3

With advanced airway- no pause

AHA ECC Adult Chain of Survival - New

BLS algorithm

ACLS

Simplified algorithm
Optimized CPR quality with monitoring
Waveform capnography (>12 mmHg)
Atropine deleted (PEA/Asystole)
Chronotropic drugs for brady, then pacing
Adenosine safe for monomorphic wide tachs
Post-cardiac arrest

Special Resuscitation Situations

Asthma

Hypothermia

Anaphylaxis

Avalanche

Pregnancy

Drowning

Morbid obesity

Electric shock/lightening

Electrolyte imbalance

Cardiac tamponade

Toxins

Cardiac surgery

Acute Coronary Syndromes

Out of hospital 12-lead
Triage to PCI
Oxygen > 94 % is the goal (capno)
Morphine use with caution in UA/non-STEMI