Top Things to Know: 2019 Focused Update on Adult and Pediatric Basic and Advanced Life Support, Neonatal Life Support, and First Aid
Published: November 14, 2019
- Over 350,000 EMS-assessed cardiac arrests and 209,000 in-hospital cardiac arrests occur annually in the US. Despite advances in resuscitation science, survival rates are only at best about 10%.
- This focused update, as with previous American Heart Association (AHA) Cardiopulmonary Resuscitation (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 to produce resuscitation updates in a timelier manner.
- This is the third annual AHA Emergency Cardiovascular Care (ECC) Focused Update. In the past, ECC Guidelines consisted of a five-year “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 adult basic and advanced cardiovascular life support and pediatric advanced life support, as well as neonatal and first aid interventions.
- For adults, this update provides continued emphasis on dispatcher instruction in CPR for adults with cardiac arrest. This update focuses on the management and strategies of advanced airways during CPR. This update addresses the use of vasopressors during cardiac arrest. There is an updated recommendation for cardiac arrest centers for adults. In addition, there is an update to the recommendation on the use of ECPR for cardiac arrest.
- For pediatrics, this update includes recommendations on dispatcher instruction in CPR for the pediatric population with cardiac arrest. This update focuses on the management and strategies of advanced airways during CPR. There are recommendations regarding the use of targeted temperature management. In addition, there are updates to the recommendation on the use of ECPR for cardiac arrest.
- There are updates on the initial oxygen concentration for preterm and term neonatal resuscitation.
- There is an update on first aid interventions for presyncope.
- These updates are based on the most recent resuscitation and first aid science and include new and updated recommendations for adult, pediatric and neonatal populations.
- 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 2019 AHA Focused Update on Adult and Pediatric Basic and Advanced Life Support, Neonatal Life Support, and First Aid aim to provide information on high-quality CPR and first aid interventions for rescuers.
Citation
- Panchal AR, Berg KM, Hirsch KG, Kudenchuk PJ, Del Rios M, Cabañas JG, Link MS, Kurz MC, Chan PS, Morley PT, Hazinski MF, Donnino MW. 2019 American Heart Association focused update on advanced cardiovascular life support: use of advanced airways, vasopressors, and extracorporeal cardiopulmonary resuscitation during cardiac arrest: an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care [published online ahead of print November 14, 2019]. Circulation. doi: 10.1161/CIR.0000000000000732.
- Duff JP, Topjian AA, Berg MD, Chan M, Haskell SE, Joyner BL Jr, Lasa JJ, Ley SJ, Raymond TT, Sutton RM, Hazinski MF, Atkins DL. 2019 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 14, 2019]. Circulation. doi: 10.1161/CIR.0000000000000731.
- Duff JP, Topjian AA, Berg MD, Chan M, Haskell SE, Joyner BL Jr, Lasa JJ, Ley SJ, Raymond TT, Sutton RM, Hazinski MF, Atkins DL. 2019 American Heart Association focused update on pediatric basic life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care [published online ahead of print November 14, 2019]. Circulation. doi: 10.1161/CIR.0000000000000736.
- Escobedo MB, Aziz K, Kapadia VS, Lee HC, Niermeyer S, Schmölzer GM, Szyld E, Weiner GM, Wyckoff MH, Yamada NK, Zaichkin JG. 2019 American Heart Association focused update on neonatal resuscitation: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care [published online ahead of print November 14, 2019]. Circulation. doi: 10.1161/CIR.0000000000000729.
- Panchal AR, Berg KM, Cabañas JG, Kurz MC, Link MS, Del Rios M, Hirsch KG, Chan PS, Hazinski MF, Morley PT, Donnino MW, Kudenchuk PJ. 2019 American Heart Association focused update on systems of care: dispatcher assisted cardiopulmonary resuscitation and cardiac arrest centers: an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care [published online ahead of print November 14, 2019]. Circulation. doi: 10.1161/CIR.0000000000000733.
- Charlton NP, Pellegrino JL, Kule A, Slater TM, Epstein JL, Flores GE, Goolsby CA, Orkin AM, Singletary EM, Swain JM. 2019 American Heart Association and American Red Cross focused update for first aid: presyncope: an update to the American Heart Association and American Red Cross guidelines for first aid [published online ahead of print November 14, 2019]. Circulation. doi: 10.1161/CIR.0000000000000730.