Top Things to Know: 2018 AHA Focused Update on ACLS and PALS
- Over 350,000 EMS-assessed cardiac arrests and 209,000 in-hospital cardiac arrests occur annually in the United States. Despite advances in resuscitation science, survival rates are only at best 11%.
- This Focused Update, as with previous AHA CPR and First Aid Guidelines, is based on the most comprehensive evaluation of resuscitation literature through the International Liaison Committee on Resuscitation (ILCOR). ILCOR has adopted a continuous evidence evaluation (CEE) process in order to produce resuscitation updates in a more timely manner.
- This is the second annual AHA ECC Focused Update. In the past, ECC Guidelines consisted of a fiveyear “batch-and-queue,” which included a comprehensive review of resuscitation science. ILCOR recently adopted a CEE process, which reviews the science as it becomes available. ILCOR will continue to evaluate questions and ECC will publish focused updates to Guidelines accordingly.
- This year’s focused update concentrates on topics in Advanced Cardiovascular Life Support and Pediatric Advanced Life Support.
- There is an update on the use of the antiarrhythmic drugs, specifically β-Blockers, immediately after ROSC in adults.
- There is an update on the use of the antiarrhythmic drugs, specifically lidocaine, immediately after ROSC in adults.
- There is an update on the use of antiarrhythmic drugs, specifically Amiodarone and Lidocaine, as well as Magnesium, in adults with shock refractory VF/pVT.
- This is an update on the use of antiarrhythmic drugs, specifically Amiodarone and Lidocaine, in children with shock refractory vF/pVT.
- Future studies are needed to investigate the prophylactic role of antiarrhythmic drugs in cardiac arrest.
- One of the primary measures to improve survival after cardiac arrest has been focused to not only improve CPR quality, but also provide early appropriate intervention coupled with CPR and defibrillation.
- Survival from both in-hospital cardiac arrest (IHCA) and out-of-hospital Cardiac arrest (OHCA) has increased over the past decade, but there is still tremendous potential for improvement. The recommendations in this 2018 Focused Update for Adult Cardiovascular Life Support and Pediatric Advanced Life Support aim to provide information on high-quality CPR for rescuers.
Citation
Panchal AR, Berg KM, Kudenchuk PJ, Del Rios M, Hirsch KG, Link MS, et al. 2018 American Heart Association focused update on advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care [published online ahead of print November 5, 2018]. Circulation. DOI: 10.1161/CIR.0000000000000613.
Duff JP, Topjian A, Berg MD, Chan M, Haskell SE, Joyner BL Jr, et al. 2018 American Heart Association focused update on pediatric advanced life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care [published online ahead of print November 5, 2018]. Circulation. DOI: 10.1161/CIR.0000000000000612.