wonder what the opinion is on the "new" ACLS guidelines

Specialties Emergency

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I just took my recert today for ACLS and found it to be incredibly dumbed-down. I am shocked the primary focus is on compressions, mainly. It is a lot easier than it was two years ago, but is this better for us, as nurses?

Specializes in Emergency & Trauma/Adult ICU.
thanks for the report - sounds like it all worked together for her benefit.... do you know what was the response time for EMS to get to her after the 911 call?

I'd be interested to know what neurological outcome is eventually as well in as it appears that she had time down without CPR.

The time estimate from the EMS crew regarding time down to return of sustainable rhythm was about 18 minutes. Estimated time from her collapse witnessed by family to initiation of CPR was about 9-10 minutes.

Sharrie, I agree that the prognosis is poor, given her down time. But we've gotten into this discussion of codes which are "successful" in the short term ...

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Specializes in Advanced Practice, surgery.
The time estimate from the EMS crew regarding time down to return of sustainable rhythm was about 18 minutes. Estimated time from her collapse witnessed by family to initiation of CPR was about 9-10 minutes.

Sharrie, I agree that the prognosis is poor, given her down time. But we've gotten into this discussion of codes which are "successful" in the short term ...

9 - 10 minutes with no CPR I am amazed you got return of spontaneous circulation and with 18 minutes before perfusing rhythm the prognosis cannot be good.

I think that successful resuscitations are going to mean different things to different people, as I have mentioned in a previous post we measure quite a few time scales, Return of circulation, survival to 60 monutes and survival to discharge and to be honest I think that survival to discharge would be my view of a successful resuscitation, but that is my personal view.

I worked with a paramedic once who taught ALS and his always taught the definition of a successful resuscitation was "a return to tax paying status"

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As someone who has worked in the ER and taken ACLS for more years than I care to admit, I get frustrated with the frequent changes and ever changing recommendations. However, I also find that the things that work have always worked---early defibrillation and good basic CPR and lots of the other stuff works only a small percent of the time. So I can understand why the emphasis is on those areas.

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Specializes in Advanced Practice, surgery.
As someone who has worked in the ER and taken ACLS for more years than I care to admit, I get frustrated with the frequent changes and ever changing recommendations. However, I also find that the things that work have always worked---early defibrillation and good basic CPR and lots of the other stuff works only a small percent of the time. So I can understand why the emphasis is on those areas.

But the guidelines don't change that frequently, there are guideline reviews every 5 years and this is to make sure that recent research is incorporated into the guidelines. It may feel as if they change more often than that but if you look at the ILCOR website you will find that the guidelines changed in 1995, 2000 and 2005 they will be due for another change in 2010 so 4 changes in 20 years is not too much

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Specializes in M/S, ER LTC.

i think it is funny how this thread changed. in my experience as an rn (5 years). i have never experienced a successful code, however i have only had 3 codes in 5 years. however you also must take into consideration that i come from a very small town (800 ppl), we have a 2 bed er and an 8 bed hospital. our closest trauma center is 150 miles away, so we just stabilize and transfer for the most part. we study acls a lot and we practice with mock codes all of the time just because we don't deal with this all of the time. there are sometimes we go for days or weeks without an er patient. it is important to remember that not everyone has a trauma team or code team when the time comes. w have an lpn that is it (he/she comes down the hall from the nursing home that is attached to the hospital to help out if need be.).:p

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Specializes in Wilderness Medicine, ICU, Adult Ed..
Since the purchase of the new AED's, ACLS on the floor is not even mentioned. It seems that the machines are considered infallable but the nurses are! I asked to have the moniters back on the crash carts and I was told that the we 'wouldn't know what we are looking at' so the moniter comes with the Rapid Response or Code Blue Teams.

Personally, after 22 years of nursing, this seemed to me lilke a major insult.

You are right. It is an insult, and a threat to patients.

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