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Dr. Kaitlin Dupuis MD CCFP

ACLS 2015: What’s new? & Exam Tip

SHORT ANSWER MANAGEMENT POP QUIZ:

  • What is the role of vasopressin in the 2015 ACLS Guidelines?

  • What FiO2 should be used during resuscitation?

  • What is the goal temperature range for cooling comatose patients after ROSC?

(Answers are in the blog post below.)

EXAM TIP:

  • Remember that “none” is a perfectly acceptable answer on the SAMPs, according to the CFPC’s website. For the first question in our Pop Quiz above, “none” is the correct answer.

ACLS:

ACLS 2015 new guidelines were just released. You should be familiar with all of the recommendations, but especially the highlights, which include:

  • Forget vasopressin.

  • Do not wait for epinephrine if no shock available or rhythm unshockable (PEA, asystole). Previous guidelines advised waiting 3-5 minutes (as always, CPR early and often).

  • Use 100% FiO2 during resuscitation and turn it back to 21% once return of spontaneous circulation.

  • ECMO is an acceptable alternative to CPR (if you’re lucky enough to work at a centre that has this readily available!).

  • Comatose patients with RSOC should be cooled for at least 24 hours (goal temp 32-36C).

  • Ultrasound can be used to confirm accurate placement of an endotracheal tube.

Remember - VFIB and pulseless VT NEED ELECTRICITY, PEA and Asystole NEED EPINEPHRINE and CPR!

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