The 2015 AHA Guidelines Update for CPR and ECC

The American Heart Association (AHA) routinely reviews its recommended guidelines for practitioners and makes updates as necessary. On October 15, 2015, they released their latest AHA guidelines, and these include some changes that you, as a certified provider of Advanced Cardiac Life Support should be aware of. 

The changes that have been implemented include those brought about by a better understanding of the effectiveness of medications and techniques as well as changes brought about by technology such as cell phones, social media and advanced medical devices. 

Some highlights include the following:

Chest Compression Depth

• Before: The adult sternum should be depressed at least 2 inches (5 cm).
• Now: During manual CPR, rescuers should perform chest compressions to a depth of at least 2 inches (5 cm) for and average adult while avoiding excessive chest compression depths (greater than 2.4 inches [6 cm]).

Chest Compression Rate

• Before: It is reasonable for lay rescuers and HCPs to perform chest compressions at a rate of at least 100/min.
• Now: In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120/min.

Impedance Threshold Devices

• Before: The use of the ITD may be considered by trained personnel as a CPR adjunct in adult cardiac arrest.
• Now: The routine used of the ITD as an adjunct during conventional CPR is not recommended. The combination of ITD with active compression-decompression CPR may be a reasonable alternative to conventional CPR in settings with available equipment and properly trained personnel.

Extracorporeal Techniques and Invasive Perfusion Devices

• Before: There was insufficient evidence to recommend the routine used of ECPR for patients in cardiac arrest. However, in settings were ECPR is readily available, it may be considered when the time without blood flow is brief and the condition leading to the cardiac arrest is reversible (eg, accidental hypothermia, drug intoxication) or amenable to heart transplantation (eg, myocarditis) or revascularization (eg, acute myocardial infarction).
• Now:  ECPR may be considered as an alternative to conventional CPR for select patients who have a cardiac arrest and for whom the suspected etiology of the cardiac arrest is potentially reversible.

Vasopressors for Resuscitation: Vasopressin

• Before: One dose of vasopressin 40 units IV/intraosseously may replace either the first or second dose of epinephrine in the treatment of cardiac arrest.
• Now: Vasopressin in combination with epinephrine offers no advantage as a substitute for standard-dose epinephrine in cardiac arrest.

You can learn more about these updates as well as the many other changes by reading the full summary of changes for 2015 here.

As always, the American Medical Resources Institute(AMRI®) team is committed to providing ACLS, PALS and BLS education and certification in compliance with the current AHA guidelines and our online course materials and exams have been updated to reflect these changes.