Part 8: Adult Advanced Cardiovascular Life Support

Abstract

t S445 advanced airway devices, ventilation rate during CPR, exhaled carbon dioxide (CO 2) detection for confirmation of airway placement, physiologic monitoring during CPR, prognostication during CPR, defibrillation, antiarrhyth-mic drugs, and vasopressors. The 2 new topics are steroids and hormones in cardiac arrest, and extracorporeal CPR (ECPR), perhaps better known to the inpatient provider community as extracorporeal life support (ECMO). The 2010 Guidelines Part on electrical therapies (defibrillation and emergency pacing) has been eliminated, and relevant material from it is now included in this ACLS Part. The major changes in the 2015 ACLS guidelines include recommendations about prognostication during CPR based on exhaled CO 2 measurements, timing of epinephrine admin-istration stratified by shockable or nonshockable rhythms, and the possibility of bundling treatment of steroids, vaso-pressin, and epinephrine for treatment of in-hospital arrests. In addition, the administration of vasopressin as the sole vasoactive drug during CPR has been removed from the algorithm.