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2015 CPR and ECC Guidelines Update
2015 CPR and ECC Guidelines Update
AHA Guidelines
2015
Ed Racht
Lynn White
First & foremost…
Methodologic
approach for evidence
evaluation &
recommendations
GRADE Guideline Tool
Developed questions
Detailed literature
review
Level of Evidence
3 (1%) are based on Level of Evidence (LOE) A
50 (15%) are based on LOE B-R (randomized studies)
46 (15%) are based on LOE B-NR (nonrandomized studies)
145 (46%) are based on LOE C-LD (limited data)
73 (23%) are based on LOE C-EO (expert opinion consensus)
Why is this so important?
ITD
The PRIMED study (n=8718) failed to demonstrate
improved outcomes with the use of an impedance
threshold device (ITD) as an adjunct to
conventional CPR when compared with use of a
sham device. This negative high-quality study
prompted a Class III: No Benefit recommendation
regarding routine use of the ITD.
Advanced Cardiac
Life Support
“The foundation of successful ACLS is good BLS”
Use of the maximal feasible inspired oxygen during CPR
was strengthened. This recommendation applies only
while CPR is ongoing and does not apply to care after
ROSC
Physiologic monitoring during CPR may be useful, but
there has yet to be a clinical trial demonstrating that goal-
directed CPR based on physiologic parameters improves
outcomes
Continuous waveform capnography remained a Class I
recommendation for confirming placement of an ETT
Advanced Cardiac
Life Support
The Class of Recommendation for use of standard dose
epinephrine (1 mg every 3 to 5 minutes) was unchanged
Vasopressin was removed from the ACLS Cardiac Arrest
Algorithm as a vasopressor therapy in recognition of
equivalence of effect with other available interventions
(epinephrine)
Recommendation against the routine prehospital cooling
of patients after ROSC by using rapid infusion of cold saline
Advanced Cardiac
Life Support
(Knowledge Gap)
http://www.medtronic.com/community-response-guide-2012/guide/
Medtronic Heart Rescue Program
Partnership
HeartRescue Partners
Center for
Resuscitation
Science
Survivors
47 | MDT Confidential
Partner Story: AMR
Survivor Support
AMR has seen a steady rise in the
number of survivors making them a
top priority.
Resources for survivors:
• Survivor Celebrations
• Survivor Support Groups
Thanks…