American Heart Association (AHA) Refresher -Updated 2020 ...
American Heart Association (AHA) Refresher - Updated 2020 Guidelines and Algorithms -
2020 Guidelines and Algorithms Update for BLS - ACLS - PALS
Katie Cooper, MS, CRNA Med-Ed.us
B L S Updates
? Early CPR is emphasized: C-A-B sequence. ? Apply AED ASAP. ? Use CPR coach with Audio Visual feedback. ? A sixth link (Recovery) has been added to the Chain of Survival. ? Enhanced algorithms and visual aids provide guidance for
resuscitation team. ? New Opioid-Associated Arrest Algorithm for Lay Responders
and healthcare workers.
Adult Chain of Survival
ACLS - Cardiac Arrest
Multimodal Neuroprognostication
A C L S Updates
P A L S Updates
? Early CPR, defibrillation and ? Post-ROSC: caregivers and
dose, high-frequency training to
epinephrine administration is
patients should be given support deliver quarterly coursework
emphasized.
for their physical, cognitive, and and practice to support the
? Use end tidal CO2 and arterial
psychosocial needs.
line BP monitoring encouraged. ? Debriefing for healthcare
mastery of high-quality CPR skills.
? Medication changes: Lidocaine
workers is beneficial to support ? Bystander CPR training should
1-1.5mg/kg or Amiodarone after well-being.
target specific socioeconomic,
Epi. Atropine dose is 1mg every ? New Cardiac Arrest in
racial, and ethnic populations
3-5 minutes for unstable
Pregnancy Algorithm has been
who have historically exhibited
bradycardia.
added to improve the chance of lower rates of bystander CPR.
? IV access preferred route of medicine administration.
successful resuscitation. ? New Opioid-Associated
? CPR training should address gender-related barriers to
? ROSC: close attn to oxygenation Emergency Algorithms added
improve rates of bystander CPR
and BP is crucial. Perc coronary for lay and trained rescuers.
intervention, multimodal
? Three options for AHA courses:
performed on women.
neuroprognostication, targeted ? 1. Instructor lead training temperature management are ? 2. Online Heartsaver
emphasized to prevent
? 3. Resuscitation Quality
hyperoxia, hypoxemia,
Improvement, or RQI?, is an
hypotension.
AHA program that uses low-
? 1 breath every 2 to 3 seconds (20-30/min). ? Use cuffed endotracheal tube (ETT) > uncuffed ETT. ? No cricoid pressure recommended. ? Early epinephrine for asystole and PEA. ? Use Arterial BP line and etCO2 capnography. ? Post ROSC: observe for seizures. ? Post-ROSC: both caregivers and cardiac arrest patients
should be given support for their physical, cognitive,
and psychosocial needs. ? Titrate fluid management and add Epi or Norepi gtts. ? Opioid OD management with CPR and naloxone. ? Use extracorporeal life support / ECMO. ? Special considerations for Congenital Heart
Disease(CHD) and single ventricle physiology. ? Pulmonary hypertension management: use of inhaled
nitric oxide, prostacyclin, analgesia, sedation, neuromuscular blockade, alkalosis induction, or ECLS
therapy.
ROSC: Return of Spontaneous Circulation
Opioid-Associated Arrests: 1. For healthcare workers
Pediatric Chain of Survival
PALS Cardiac Arrest Algorithm
Pregnancy
2. For Lay Responders
Pediatric Bradycardia with a Pulse
Pediatric Tachycardia with a Pulse
Source: American Heart Association 2020 ECC Guidelines and Updates
Med-Ed.us
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