Expectations for the 2015 AHA Guidelines

Posted by Wilson Rapp | Medical Education

Oct 13, 2014

Update: The 2015 AHA Guideline Updates for CPR and ECC were released on October 15, 2015.  We will be releasing multiple posts covering the details of these updates in the weeks following the updates' release.  You can click on the following links to be directed to these recent posts:

- Key Changes to the 2015 Update


A brief compilation of the latest speculations expected for the 2015 AHA / ILCOR CoSTR Guidelines.


As of today, we are roughly one year away from the official release date of the 2015 AHA / ILCOR CoSTR Resuscitation Guidelines. More importantly, we are less than four months away from the 2015 ILCOR Conference, during which, healthcare professionals from around the globe will gather to determine what will be included with the 2015 updates. In anticipation for this conference, we are compiling a list of the speculated updates currently being discussed amongst the medical community.

  

A Brief AHA / ILCOR History

Before diving into 2015, let’s cover some history. For decades, the American Heart Association (AHA) has been the leader for resuscitation and life support training amongst healthcare professionals in the United States. The AHA has provided numerous emergency resuscitation-training programs, including Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) and Basic Life Support (BLS). Similar courses were likewise offered for healthcare professionals living and working internationally. Despite advances made in resuscitation procedures and consequent training programs over the years, the medical community lacked a single, global organization and a universally agreed upon set of emergency resuscitation guidelines.

  

In 1992, the International Liaison Committee on Resuscitation (ILCOR) was formed to provide a forum for the leading resuscitation experts and organizations. In collaboration with representatives from the AHA, European Resuscitation Council (ERC), the Heart and Stroke Foundation of Canada (HSFC) and other related organizations, the first international CPR Guidelines were published in 2000.

  

Every five years, an updated set of resuscitation guidelines are released by ILCOR: the 2005 International Consensus on CPR and ECC (Emergency Cardiovascular Care) Science with Treatment Recommendations, and the 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. ACLS, PALS and BLS Certification courses currently utilize guidelines released in 2010. A few of the recent updates include:

  

– An adjustment to the CPR process from A – B – C (Airway – Breathing – Compressions) to C – A – B

  

– An increased emphasis on High – Quality CPR

  

– Revoking previous recommendations for performing cricoid pressure

  

See a full list of the 2010 Updates

  

We are now nearing decision time for 2015’s list. In February, the leading resuscitation experts and other medical experts from around the world will meet in Dallas, TX to determine what will change – and what will remain.

  

What Can We Expect?

Though there is no guarantee for what will be included in these next guidelines, many possibilities are already being discussed. The following is just the beginning of our expectations list leading up to February’s conference:

  

Further Emphasis on High-Quality CPR. Though this was included with the 2010 guidelines, it is believed the 2015 guidelines will expand on the specifics of High-Quality CPR. A “sweet spot” for the rate of chest compressions of 100 – 120 may be established. Supporting research has shown a slower compression rate may restrict the heart muscles from perfusion, while a faster compression rate puts providers at risk of performing less effective compressions, and/or making mistakes during the CPR process. Source

  

Emphasis on Unwitnessed Heart Attacks. Discussions have been raised about differentiating procedures necessary for treating individuals suffering a heart attack event void of any witnesses versus an event that occurs within the company of others. One popular prevention strategy that could receive attention during the ILCOR conference involves at-risk individuals utilizing wearable monitoring devices. These devices could constantly monitor an individual’s peripheral perfusion and would alert nearby bystanders or even EMS when changes occur. Taking into consideration the variety of wearable devices that have recently been released by popular technology companies like Apple, Sony and Samsung and others, this could climb in the list of possible updates. Source

  

ROSC will Receive Welcomed Attention. Due to the improvements made in emergency resuscitation procedures over the past decade, survival rates of cardiac arrest victims have risen. As a result, the practices that accompany Return of Spontaneous Circulation (ROSC) are becoming increasingly important. This may be one of the more welcomed additions in 2015. Source

  

De-Emphasis on Hypothermia. Current treatments for hypothermic patients are being threatened by evidence released during a 2013 study released in the New England Journal of Medicine. The study provided evidence confirming no difference existed in patient outcomes when body temperatures were cooled to 33 degrees Celsius, as compared to 36 degrees Celsius. During an interview with the ACP (American College of Physicians) Internist, Dr. Michael O’Connor, Chief of the Critical Care Section of the University of Chicago Medicine’s anesthesiology department, revealed the study’s findings are, “important because hypothermia is logistically difficult and expensive. This is not the last word, but it certainly will change practice at many institutions.” Dr. O’Connor reported his organization has cutback on cooling practices, and he expects others will follow suit. Source

  

Extension for Recommended CPR Performance Duration. Dr. O’Connor also believes the duration for CPR performance will be a topic of discussion in February, referencing a 2012 study which found increased percentages of ROSC occurrences for inpatients receiving CPR for a period of up to 45 minutes. Source

  

What’s Next?

These are only a few possible topics being discussed, and more will inevitably be brought into question as February’s conference nears. Over the next few months, we will continue to monitor the rumors published by members of the medical community, and we will update our own list accordingly. During this time, we’d also love to hear your opinions, share any rumors you stumble upon and share your own expectations prior to the ILCOR Conference. Email us with any information you would like to share. At this point, all we can say for certain is that, regardless of all the rumors and expectations, we are eagerly awaiting these next updates, currently set for an October 15th, 2015 release date.

  

Individuals needing to complete an ACLS, PALS, and/or BLS Certification or Recertification course in 2015 can satisfy these requirements through the courses offered by eMedCert.  We offer fully online courses that can be completed from the comfort of your own home, and at your own pace.  For more information on our courses, we encourage you to visit our course pages here:

  

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