Latest ILCOR Guidelines and Updates on ACLS, CPR, PALS, and BLS Content
Latest ILCOR Guidelines and Updates on ACLS, CPR, PALS, and BLS Content
by Greta Kviklyte
Life Saver, AMC
Co-authored by Kim Murray, RN, M.S.
posted on Oct 15, 2023, at 10:47 pm
The Latest ILCOR Guidelines (2020-2025) and Its Overview
ILCOR updates its guidelines and recommendations every five years, with the most recent update spanning from 2020 to 2025. In addition to these cyclic updates, continuous research and evidence evaluation are undertaken, enabling us to refresh our training material as new recommendations emerge. This approach ensures that our life-saving content remains current, empowering our lifesavers with the most up-to-date information. Over the past year, our content has seen several critical updates based on these evolving guidelines.
Key Changes in CPR Guidelines
The most recent ILCOR guidelines revised the vital role of early intervention in CPR. Early initiation of compressions and breaths helps mitigate oxygen depletion and enhances blood flow, a crucial factor in preventing cardiac arrest. Our content has been tailored to show the significance of bystander intervention in such scenarios.
Upon calling for help, rescuers should promptly initiate CPR. When reaching out for assistance, utilizing a speakerphone for a hands-free call is recommended. Our content now emphasizes specialized instructions for ensuring scene safety and provides guidance on actions to take during an emergency while awaiting medical professionals or a response team.
Furthermore, the latest guidelines distinguish between child and infant CPR recommendations based on whether CPR is performed by a single rescuer or a team of two or more rescuers.
Updates in CPR Procedure
The most recent recommendations highlight starting CPR with compressions before focusing on ventilation. This updated CPR procedure is now known as C-A-B, emphasizing compressions, airway, and then breaths.
It is recommended to perform CPR on a sturdy surface, although effective compressions can still be achieved on a softer surface by adjusting compression depth. However, the latest guidelines suggest moving a patient from a bed to the floor if feasible, to ensure a more stable surface.
Regardless of one’s medical background or experience, everyone can acquire the skills to perform CPR and potentially save a life. To gain a deeper understanding of CPR and be prepared for life-threatening situations, consider enrolling in a CPR, AED, and First Aid online course today.
We have incorporated all these updates into our CPR and BLS courses and all training materials.
Updates in Child and Infant CPR, PALS, and BLS
The differentiation between interventions conducted by a single rescuer and those involving a team of two or more individuals has not only affected CPR but has also influenced the content of both Pediatric Advanced Life Support (PALS) and Basic Life Support (BLS). Our guidelines encompassing these areas have been revised to harmonize with the notable shifts in CPR, airway management, and rescue breath delivery. Presented below are the latest recommendations for administering CPR, tailored for both solo rescuers and teams with two or more members.
Single rescuer guidelines:
- Perform 5 sets of CPR quickly before seeking additional help.
- Each set comprises 30 compressions and two breaths.
Two rescuer guidelines:
- Perform 10 sets of CPR quickly before seeking additional help.
- Each set comprises 15 compressions and two breaths.
The guidelines outlined below, derived from the latest recommendations by ILCOR, present variations in airway management protocols for children or infants facing cardiac arrest, contingent on the rescuer count. Additionally, the updated compression-to-breath ratios differ based on the presence or absence of an advanced airway. Utilizing an advanced airway, such as a supraglottic airway, laryngeal mask airway, or endotracheal tube, offers a more secure method for administering breaths. When promptly introduced in the initial stages of resuscitation it may improve stability in delivering breaths.
Single rescuer guidelines for advanced airway:
- Administer one breath every 6 seconds seamlessly without pausing compressions.
- Target a rate of 10-15 breaths per minute.
Two rescuer guidelines for advanced airway:
- Administer one breath every 2-3 seconds seamlessly without pausing compressions.
- Target a rate of 20-30 breaths per minute.
Single rescuer guidelines for no advanced airway:
- Execute 30 compressions, then administer 2 breaths.
Two rescuer guidelines for no advanced airway:
- Execute 15 compressions, then administer 2 breaths.
Take note of the recent updates in adult airway management. If using an advanced airway, provide one breath every 6 seconds without interrupting compressions for adults. If you seek a thorough grasp of pediatric guidelines aligned with the latest ILCOR recommendations, think of enrolling in a Pediatric Advanced Life Support course.
Updates on ACLS for 2020-2025
Understanding the paramount importance of teamwork and collaborative synergy, our Advanced Cardiac Life Support (ACLS) curriculum has been thoughtfully enhanced to incorporate a dedicated section shedding light on the intricacies of effective team dynamics within the resuscitation team. This resuscitation team serves as a fundamental and essential pillar in advanced life support, with its seamless functioning and harmonious teamwork proving to be pivotal in attaining successful outcomes. The collaborative efforts among medical professionals within this team, each contributing their expertise and skills, result in a well-coordinated and swift response during critical situations, ultimately enhancing the chances of successful resuscitation and optimal patient care.
Understanding Targeted Temperature Management (TTM) and its Advancements
We’ve updated our previously focused sections on therapeutic hypothermia to cover all aspects of targeted temperature management (TTM). Our revised section delves into the intricate details of achieving and maintaining a specific body temperature tailored to the unique needs of each individual. Understanding the delicate balance and nuances involved in TTM is crucial for optimizing outcomes, especially in critical medical situations. The updated guidance we provide offers in-depth insights and practical strategies, empowering healthcare professionals to implement precise temperature management techniques and thereby, improve patient care and recovery outcomes across a spectrum of medical conditions and scenarios.
Updated Approach to Drug Administration in ACLS
When facing significantly low blood pressure in individuals outside of cardiac arrest, the top choices for pressor agents are dopamine and norepinephrine. Vasopressin and phenylephrine are used as alternative agents, while epinephrine is reserved for cases of severe hypotension or as a last-resort option. Epinephrine continues to be the recommended vasopressor during cardiac arrest.
Regarding administering drugs to adults during cardiac arrest, ILCOR now advocates initiating the intravenous (IV) route as the primary choice. In the event of unsuccessful IV attempts or impractical IV access, the intraosseous (IO) route is recommended as an alternative. The long-term effects of drug administration via IV or IO routes are still being studied; however, currently, ILCOR researchers from the Advanced Life Support (ALS) Task Force prefer the IV route. To stay updated on these developments, it is recommended to undergo ACLS recertification at least once every two years.
Our current material also incorporates revised dosages for commonly used drugs. For symptomatic bradycardia treatment, we now advise administering a 1mg dose of Atropine every three minutes, departing from the prior .5mg dosage. Although the maximum dopamine dose remains at 20mg, we have adjusted the range to a 5-20mcg/kg/min dose for treating shock/CHF and symptomatic bradycardia.
News in ACLS: Expanding Knowledge and Understanding Rhythms
Newly introduced in our Advanced Cardiac Life Support (ACLS) content is the FAST acronym, originating from the Cincinnati Pre-Hospital Stroke Scale. The FAST acronym serves as a valuable tool to evaluate potential stroke symptoms in individuals. It prompts assessment of an individual’s:
- Arms, and
Assessment emphasizes the importance of noting the time required for evaluation and immediate contact with emergency services.
The post-cardiac arrest recovery process can be extensive and should extend well beyond the initial hospitalization. Our content has been enhanced to emphasize the vital importance of a thorough evaluation and ongoing assistance following a cardiac arrest. We’ve introduced a comprehensive checklist for post-cardiac arrest care, aptly represented by the acronym ‘VOMIT,’ which underscores the evaluation of five critical aspects in post-cardiac arrest patients:
- Vital signs,
- Oxygen levels,
- Myocardial infarction considerations,
- IV access, and
- Targeted Temperature Management.
Our major enhancement involves the introduction of a completely new section focusing on ACLS Rhythms and Interpretation. Within this section, we provide a comprehensive overview of prevalent categories of ACLS rhythms and identify the most common ACLS rhythms.
Current Advancements in First Aid and Basic Life Support
Addressing FBAO – Foreign Body Airway Obstruction
Foreign Body Airway Obstruction, commonly referred to as ‘choking,’ ranks as the fourth leading cause of unintentional death in the United States. Given its critical nature when left unaddressed, this subject undergoes continual evaluation. The ILCOR task force has recently updated its recommendations for alleviating FBAO.
In the case of conscious adults and children above the age of one, the current approach involves commencing with back slaps and progressing to abdominal thrusts if back slaps do not prove effective. On the other hand, for unconscious adults and children, chest thrusts are now recommended. Stay updated on these life-saving techniques and recommendations by pursuing Basic Life Support certification or recertification.
COVID-19 and its Impact on First Aid and Basic Life Support
Following the onset of the COVID-19 pandemic, the ILCOR has provided insights into the potential implications of the virus on resuscitation efforts. Despite the contagious nature of the pandemic, the ILCOR encourages lay rescuers to administer CPR when feasible, underlining the importance of utilizing suitable Personal Protective Equipment (PPE) to protect against the virus.
As a response to the pandemic, we have created precise algorithms for managing suspected or confirmed COVID-19 patients. These algorithms empower rescuers to perform life-saving interventions on these individuals without compromising their own safety. We maintain a steadfast commitment to updating our content in line with the latest findings and conclusions from ongoing COVID-19 studies by the ILCOR.
Looking Ahead: ILCOR Continually Releases New Recommendations
Medical knowledge is constantly evolving and being updated for everyone’s needs. We are dedicated to reviewing the research and staying abreast of the latest advancements as the ILCOR continually releases new recommendations. Maintaining current knowledge in healthcare is crucial for not only improving your expertise but also for enhancing patient satisfaction. By employing the latest methods and technologies, patients can trust that they are receiving top-notch care, leading to increased trust and confidence in your medical practice.
It’s crucial to stay informed about the most up-to-date guidelines, and here at Advanced Medical Certification, we are committed to ensuring our life-saving information remains precise and current. Make it a habit to frequently visit our Journal Articles for the most recent updates. Meanwhile, consider enrolling in one of our courses today to ensure you have the latest life-saving information at your fingertips! Feel free to share your learning experience in the comments section below.