Advanced Cardiac Life Support (ACLS)

Interim Bridge Materials for 2006

ACLS Instructor Manual Changes and Notes to Instructors

Goal: Enable ACLS Instructors the ability to teach ACLS Provider and Provider Renewal courses with the
new science of 2005, in the existing ACLS Instructor Manual, (published 2001), until final published materials are available.

Please refer to the 2001, Instructor’s Manual for Advanced Cardiac Life Support

Page(s) Guidelines 2000 Replace with the following Additional comments, resources
information
7, 8 CPR-AED Skill Sheet Use 2005 Guidelines
AED-BLS Skill Sheet
10, 11, 56,71, 91, 92, References to 2000 2006 Handbook of Emergency 2006 ECC Handbook will be available
106 Handbook of Emergency Cardiovascular Care for Healthcare 1/16/06
Cardiovascular Care for Providers
Healthcare Providers

3,11,35,41,53,71, 73, References to 2000 2005 Guidelines 2005 Guidelines is available on-line or by
91, 92 Guidelines ordering from AHA partnered companies
83 Renewal criteria Teach 3 courses in previous 2 years Training memo: 2006 Training
Attend ACLS Science update Requirements for New Science and
Attend ACLS product orientation Materials dated 1/3/06
Complete Core Instructor Course Training memo: AHA Core Instructor
Course dated 1/3/06
Pages(s) Guidelines 2000 Replace with the following Additional comments, resources
information
147, 148 - Case #1 Opens airway- If C-spine If this maneuver does not open the See Bridge materials notes

© 2006 American Heart Association, Inc.

 Advanced Cardiac Life Support (ACLS)
Interim Bridge Materials for 2006

Critical Actions injury is suspected use a airway, use a head-tilt-chin lift

jaw thrust technique. Manual stabilization of
the neck and head during CPR
should be utilized rather than
immobilization devices.
Starts rescue breathing at Starts rescue breathing at 1 every 5 Give breaths over 1 second that cause
1 every 5 seconds to 6 seconds visible chest rise.
Place an advanced Insertion may interrupt chest
airway as soon as compressions: evaluate the need for
possible an advanced airway
FBAO treatment Look in the mouth when opening the Tongue jaw lift no longer taught. Blind
airway finger sweeps have been eliminated
149, 150 – Case #2 After 3 analyze/shock Unless AED trainer is programmed See Bridge materials notes
Critical Actions cycles….. to utilize 1 shock followed by 2 Use AED-BLS skill sheet
minutes (5 cycles) of CPR, AED
trainer should be shut off after first
shock and the rest of the sequence
simulated by instructor
Apply AED Don’t interrupt CPR to apply
patches
Compression to 30:2 compression to ventilation
Ventilation ratio
Compressions Push hard, Push fast. Compressions
at rate of 100/minute. Allow full
chest recoil.
Ventilations See notes from Case #1 re
ventilations

Pages(s) Guidelines 2000 Replace with the following Additional comments, resources
information
151, 152 – Case #3 CPR See notes on changes in Cases #1 See Bridge materials notes

© 2006 American Heart Association, Inc.

 Advanced Cardiac Life Support (ACLS)
Interim Bridge Materials for 2006

Critical Actions and #2

Defibrillation 1 shock is recommended
energy: 360J monophasic;
150J-200J for biphasic truncated
exponential waveform,
120 J for biphasic rectilinear
Subsequent doses: same or higher
Drug – Shock CPR – Shock – CPR – Vasopressor Emphasis on immediate CPR and minimal
interruptions. No rhythm check until after
2 minutes of CPR.

IV Establish line without interrupting

CPR.
Medications Use Epinephrine or Vasopressin for
the vasopressor. If amiodarone is
unavailable, lidocaine may be
considered
153, 154 – Case #4 CPR See notes on changes in Cases #1 See Bridge materials notes
Critical Actions and Case #2
Medications Epinephrine or Vasopressin can be
utilized. Atropine may be given up
to 3 doses

155, 156 – Case #5 CPR See notes on changes in Cases 1, 2 See Bridge materials notes
Critical Actions “Gives 2 ventilations 30:2 compression ratio for single
every 15 compressions; rescuer. 15:2 for HCP 2 rescuers.
uses at least 2 seconds to Breaths given 1 breath/second
squeeze bag….”
Medications Atropine may be given up to 3 doses
Page(s) Guidelines 2000 Replace with the following Additional comments, resources
information

© 2006 American Heart Association, Inc.

 Advanced Cardiac Life Support (ACLS)
Interim Bridge Materials for 2006

157, 158 – Case #6 Medications EMS dispatch may instruct patients See Bridge materials notes
Critical Actions to chew an aspirin
Patient risk factors Additional information on
identification of high risk patients
Fibrinolytics Criteria updates
159 – Case #7 Atropine Atropine dose is 0.5 mg, dose may See Bridge materials notes
Critical Actions repeated to total 3 doses
Isoproterenol Isoproterenol not recommended
Causes H’s and T’s should be considered
161, 162 – Case #8 Obtains and reviews 12- Performs rapid, problem focused See Bridge materials notes
Critical Actions lead ECG history should precede 12-lead
Biphasic energy levels 100 – 120 J biphasic – atrial flutter
generally require less energy
Polymorphic VT Treat as VF
Causes H’s and T’s should be considered
Expert consultation Emphasis on obtaining expert
consultation
163, 164 – Case #9 Algorithm classifications Subdivided into wide or narrow and See Bridge materials notes
Critical Actions regular or irregular
Atrial fibrillation/Atrial Narrow irregular rhythms,
flutter recommend expert consultation
Medications Adenosine dose should be reduced if
central venous access, transplanted
hearts or patients taking
dipyridamole or carbamazepine
Amiodarone if an antiarrhythmic is
needed
165, 166 – Case #10 Specialized care Emphasis on transport to specialized See Bridge materials notes
Critical Actions qualified stroke care units.

© 2006 American Heart Association, Inc.