![]() ![]() 6 – 8 When passive oxygen delivery using a fenestrated tracheal tube (Boussignac tube) during uninterrupted physician-managed CPR was compared with standard CPR, there was no difference in oxygenation, ROSC, or survival to hospital admission. In the out-of-hospital setting, passive oxygen delivery via mask with an opened airway during the first 6 minutes of CPR provided by emergency medical services (EMS) personnel was part of a protocol of bundled care interventions (including continuous chest compressions) that resulted in improved survival. Positive-pressure ventilation has been a mainstay of CPR but recently has come under scrutiny because of the potential for increased intrathoracic pressure to interfere with circulation due to reduced venous return to the heart. ![]() There is an increased emphasis on physiologic monitoring to optimize CPR quality and detect ROSC.Ĭhronotropic drug infusions are recommended as an alternative to pacing in symptomatic and unstable bradycardia.Īdenosine is recommended as a safe and potentially effective therapy in the initial management of stable undifferentiated regular monomorphic wide-complex tachycardia. Key changes from the 2005 ACLS Guidelines includeĬontinuous quantitative waveform capnography is recommended for confirmation and monitoring of endotracheal tube placement.Ĭardiac arrest algorithms are simplified and redesigned to emphasize the importance of high-quality CPR (including chest compressions of adequate rate and depth, allowing complete chest recoil after each compression, minimizing interruptions in chest compressions and avoiding excessive ventilation).Ītropine is no longer recommended for routine use in the management of pulseless electrical activity (PEA)/asystole. Part 8 presents the 2010 Adult ACLS Guidelines: 8.1: “Adjuncts for Airway Control and Ventilation” 8.2: “Management of Cardiac Arrest” and 8.3: “Management of Symptomatic Bradycardia and Tachycardia.” Post–cardiac arrest interventions are addressed in Part 9: “Post–Cardiac Arrest Care.” Following ROSC, survival and neurologic outcome can be improved with integrated post–cardiac arrest care. For the treatment of cardiac arrest, ACLS interventions build on the basic life support (BLS) foundation of immediate recognition and activation of the emergency response system, early CPR, and rapid defibrillation to further increase the likelihood of ROSC with drug therapy, advanced airway management, and physiologic monitoring. ACLS interventions aimed at preventing cardiac arrest include airway management, ventilation support, and treatment of bradyarrhythmias and tachyarrhythmias. Customer Service and Ordering InformationĪdvanced cardiovascular life support (ACLS) impacts multiple key links in the chain of survival that include interventions to prevent cardiac arrest, treat cardiac arrest, and improve outcomes of patients who achieve return of spontaneous circulation (ROSC) after cardiac arrest. ![]() Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB). ![]()
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