Updates to the Newest ACLS guidelines
Vasopressin should no longer be administered during a cardiac arrest.
Chest Compressions Rate
The rate of chest compressions has been increased from 100 compressions/min to anywhere between 100 – 120 compressions/min.
After placement of an advanced airway, rescuers should deliver 1 breath every 6 seconds while continuous chest compressions are being performed, instead of performing 30 compressions and stopping to allow for 2 rescue breaths.
Rescuers should administer epinephrine as soon as possible in a patient with a nonshockable rhythm. There is no longer a specific guideline in patients with a shockable rhythm.
Chest Compression Depth
Chest compressions on an adult should be atleast 2 inches (5 centimeters), but no more than 2.5 inches (6 centimeters).
Atropine should not be administered before intubation in infants and children in cardiac arrest.
All comatose adult patients with ROSC after cardiac arrest should be maintained at a constant temperature between 32 degrees C and 36 degrees C for at least 24 hours.
After intubation, continuous waveform capnography is recommended in addition to clinical assessment to confirm and monitor placement. Ultrasound can be performed if no capnography is available.
In intubated patients, failure to achieve an ETCO2 of > 10 mm Hg by waveform capnography after 20 minutes of CPR suggests resuscitation failure.
Cardiac Arrest During Pregnancy
When a pregnant woman goes into cardiac arrest and the fundal height is at or above the umbilicus, emergency C-section should performed if there is no ROSC within 4 minutes.