Friday, January 15, 2010

ACLS Guidelines

 When I was a kid, I couldn't wait for the Street and Smith's Annual Baseball issue to hit the newsstand so I could check out how their experts thought the Red Sox would be in that coming spring -- what was the projected lineup? Who were the hot rookies? Who would win the pennant?

Now I wait every five years for the American Heart Association's ECC Guidelines. What kind of CPR will we be doing? Any changes in ALS drugs? What about airway -- delayed or immediate intubation? Any new interventions or devices?

I particularly look forward to the AHA ECC science book which goes into detail about all their recommendations in far more depth than the student handbook for the ACLS class. This material is what I believe will be published on-line in October, and later made available in print.

Here is the 2005 version:

2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

The time for the 2010 edition is rapidly approaching,

Check out the video below from the EMS1 network, which says the guidelines will be out on October of this year.

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After watching, you can go to this web site, International Liaison Committee on Resuscitation (ILCOR)
and read some of the 100s of worksheets which give some hint of the areas they are looking at, including the following:

In patients with suspected ACS and normal oxygen saturations, does the use of supplemental oxygen, compared with room air, improve outcomes?

In adult cardiac arrest, does the use of a supraglottic airway device vs an endotracheal tube, improve any outcomes."

In adult cardiac arrest, does the use of the Autopulse compared with manual CPR, improve any outcomes?

In adult patients in monomorphic (wide complex) tachycardia, does the use of any drug or combination of drugs compared with not using drugs (or a standard drug regimen), improve outcomes?

“In adult patients with ROSC after cardiac arrest who have cardiovascular dysfunction, does the use of any specific cardio-active drugs or other intervention as opposed to standard care (or different cardio active drugs), improve outcome?”

In adult and pediatric patients in cardiac arrest, does the use of passive oxygen delivery during CPR compared with oxygen delivery by positive pressure ventilation improve outcome?

“In adult patients suffering from a cardiac arrest does calling of EMS and starting chest compressions (without ventilation) by trained laypersons or professionals compared with calling EMS and starting chest compressions plus rescue breathing improve survival to hospital discharge?”

In victims with suspected cervical spinal injury does spinal immobilization benefit the patient over doing nothing in outcome?

These worksheets will serve as the basis for discussion for a panel of experts who will decide on final recommendations that will eventually make their way the street.

Stay tuned...