2015 ACLS updates

[paramedicmike]

Some interesting changes coming from AHA with their 2015 ACLS updates.  For example, Vasopressin is out.  Epinephrine is the first round drug of choice.  Ultrasound is an option for ETT placement (likely more hospital based but interesting for any prehospital systems using u/s).  In non-shockable rhythms give epi early.  Lots of oxygen during CPR; if/when ROSC returns titrate as necessary. 

A hospital based intervention which I thought was interesting was ECMO in place of CPR if available.

From an academic point of view it's interesting to trend the changes over time.  It's interesting to watch the research.  It'll be interesting to see what comes next.

[Just Plain Ruff]

 Lots of oxygen during CPR    

 

I thought oxygen was bad!!!!!!  (sprry, my sarcasm button didn't get turned off today)

Edited December 29, 2015 by Ruffmeister Paramedic

[Off Label]

Some interesting changes coming from AHA with their 2015 ACLS updates.  For example, Vasopressin is out.  Epinephrine is the first round drug of choice.  Ultrasound is an option for ETT placement (likely more hospital based but interesting for any prehospital systems using u/s).  In non-shockable rhythms give epi early.  Lots of oxygen during CPR; if/when ROSC returns titrate as necessary. 

A hospital based intervention which I thought was interesting was ECMO in place of CPR if available.

From an academic point of view it's interesting to trend the changes over time.  It's interesting to watch the research.  It'll be interesting to see what comes next.

Have not seen the particulars, but very surprised to see ultrasound in the airway discussion. With all of the video assistive devices now available, if the scramble becomes so desperate as to make someone think ultrasound, might it not be time for the surgical airway? I think I saw the vasopressin thing coming.

Edit: after reading the AHA document on the 2015 changes, I see that the use of ultrasound is only for tube placement confirmation, not placement.

 

Edited December 29, 2015 by Off Label

[chbare]

Targeted temperature management in the ROSC patient is one of the bigger changes. 

[ffemtp1988]

The way I read it, Vasopressin wasn't out.  Epi was preferred for V-fib and V-Tac and Vasopressin was still considered for Asystole/PEA.  I think the trend is definitely emerging that we are treating V-Fib/V-Tac differently than Asystole/PEA.

[Off Label]

The way I read it, Vasopressin wasn't out.  Epi was preferred for V-fib and V-Tac and Vasopressin was still considered for Asystole/PEA.  I think the trend is definitely emerging that we are treating V-Fib/V-Tac differently than Asystole/PEA.

Vasopressin was removed in the interests of simplifying the process. A study found no difference between epi and vasopressin, so they got rid of vasopressin. That could have just meant they're equally useless in certain situations.

That said, IME, if epi can't fix dead, nothing can.

[Just Plain Ruff]

Vasopressin was removed in the interests of simplifying the process. A study found no difference between epi and vasopressin, so they got rid of vasopressin. That could have just meant they're equally useless in certain situations.

That said, IME, if epi can't fix dead, nothing can.

and many times you can't kill em any deader. 

 

[Off Label]

and many times you can't kill em any deader. 

 

ha!

[1EMT-P]

The AHA never ceases to amaze me, they always find interesting & new ways to update their courses!