REBEL Cast Wee: Our Top 5 AHA 2015 Guideline Updates for CPR and ECC

In case you have not heard or not read it on the twittersphere, the American Heart Association just released their 2015 Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) in Circulation. I am joined by Mr. Security, Matt Astin for this episode and we both read through this massive 15 part document and came up with our top 5 updates and recommendations. Now this is just a list of our top 5 new or updated recommendations, that caught our attention, but certainly there are other recommendations. If you want the cliff notes version of the updates look through part I, titled the executive summary or the Highlights PDF which we will attach on the blog, but certainly as always we recommend reading the full document to form your own interpretations and opinions. October 2015 REBELCast Wee Podcast Click here for Direct Download of Podcast AHA Strength of Recommendation and Quality of Evidence Our Top 5 AHA 2015 Guideline Updates for CPR and ECC Vasopressin is Out (Part 7: Adult Advanced Cardiovascular Life Support, S451): The AHA has determined that Vasopressin offers no advantage as either a substitute for or in combination with standard-­‐dose epinephrine in cardiac arrest (ClassIIb, LOE B-­‐R). The old 2010 recommendation was one dose of vasopressin 40U IV or IO could be used as a replacement either as a first or second dose for epinephrine in the treatment of cardiac arrest. Both Vasopressin and Epinephrine have been shown to increase ROSC in OHCA, and the best available evidence shows that the efficacy of the 2 drugs to achieve this is similar. Therefore for the sake of simplicity the AHA decided to remove Vasopressin from the ACLS algorithm. Some may argue that the Vasopressin, Steroid, Epinephrine Study (Mentzelopoulos SD et al) may argue against this recommendation. First this was a study of IHCA not OHCA. In IHCA the recommendation is the combined use of epinephrine, steroid, and vasopressin MAY BE considered, but further studies are needed before the routine use of this strategy can be recommended (ClassIIb, LOE C-­‐LD). Acute Coronary Syndrome Risk Stratification (Part 9: Acute Coronary Syndrome, S485): The updated recommendations state that a negative cTnI or cTnT measurement at 0 and between 3 – 6 hours may be used together with very low-­‐risk stratification strategy (i.e. TIMI Score = 0, Low-­‐Risk Score per Vancouver Rule, North American Chest Pain Score = 0 and age