2005 AHA BLS and ACLS Summery
Healthcare Provider
CPR/Rescue Breathing Adult and Older Child Child (1-14 years) Infant (<1 year)
Activate EMS First
Activating EMS – Lone Rescuer
Hypoxic Arrest: Call after 2
Check responsiveness
min. of CPR
Head tilt-chin lift
Open airway
(If trauma is present, use jaw
(Head tilt-chin lift or jaw thrust)
thrust)
Check for breathing:
(Look, listen, feel))
If victim is breathing: place in
recovery position. If victim is not
breathing: Give 2 effective breaths
Initial 2 effective breaths
at 1 sec/breath
Rescue Breathing 1 breath / 5-6 seconds
Rate via Endotracheal tube (ET) If via ET: 1 breath / 6-8
SLOWER seconds
If not adequate:
Adequate Breathing Provide Rescue Breathing
Abdominal thrusts
Foreign-body airway obstruction
Unresponsive: CPR & NO
(CHOKING)
Blind finger sweeps
Pulse Check:
Carotid
Check X 10 seconds or less
When to Provide Compressions? Pulse Absent
Center of chest, between
Compression landmarks
nipples
Compression method
2 Hands: Heel of one hand,
Push Hard & Fast, allow chest
other hand on top.
recoil
1 ½ to 2 in
Compression depth
(4 to 5 cm)
Compression rate 100/min
Compression-ventilation ratio 30:2 (1 or 2 rescuers)
Perform 2 min. or 5 cycles
of CPR immediately after
AED shock(s) delivered.
Use Adult pads only.
1
Call after 2 min. of
Call after 2 min. of CPR
CPR
Sudden, witnessed
Sudden, witnessed
arrest: Activate First
arrest: Activate First
Head tilt-chin lift Head tilt-chin lift
(If trauma is present, use (If trauma is present,
jaw thrust) use jaw thrust)
2 effective breaths 2 effective breaths
at 1 sec/breath at 1 sec/breath
1 breath / 3-5
1 breath / 3-5 seconds
seconds
If via ET: 1 breath / 6-8
If via ET: 1 breath / 6-
seconds
8 seconds
If no breathing: If no breathing:
Provide Rescue Provide Rescue
Breathing Breathing
Back blows and chest
Abdominal thrusts thrusts
Unresponsive: CPR & Unresponsive: CPR &
NO Blind finger sweeps NO Blind finger
sweeps
Carotid or Femoral Brachial or Femoral
HR < 60 with signs of HR < 60 with signs of
poor perfusion poor perfusion
Center of chest, between
Just below nipple line
nipples
1-rescuer: 2 fingers
1 Hand or 2 Hands:
2-rescuers: 2 thumbs-
Use heel of hand(s)
encircling hands
1/3 to ½ the depth of the 1/3 to ½ the depth of
chest the chest
100/min 100/min
1-rescuer: 30:2 1-rescuer: 30:2
2-rescuers: 15:2 2-rescuers: 15:2
In Hospital: Apply
immediately.
Out-of-Hospital: 2 min.
CPR first. Not recommended
1-8 years: use child
pads. If Child pads not
available, use Adult pads
 2005 CPR Changes
From: American Heart Association

For more information, click this link:

http://www.americanheart.org/presenter.jhtml?identifier=3035517

Basic Life Support (BLS)

►“Push Hard, Push, Fast” for chest compressions – 100/min – allow chest recoil
►Minimize interruptions in chest compression – keep at 10 seconds or less

►Single rescuer compression to ventilation ratio for ALL* ages: 30:2

►Two rescuer compression to ventilation ratio for ADULT: 30:2
►Two rescuer compression to ventilation ratio for INFANT & CHILD: 15:2

►Chest compression technique: ▪ Child – 1 or 2 hands

►Compression landmarks: ▪ Adult - Center of chest, between nipples

▪ Child - Center of chest, between nipples
▪ Infant – Just below nipple line

►Two rescuer CPR technique: ▪ Rotate compressor role every 2 min.

►AED shocks: ▪ 1 shock followed immediately by 2 minutes /5 cycles CPR

▪ No pulse check or rhythm check after shock
▪ AED algorithms will need to be modified
▪ Continue to use AEDs as is until further notice

► “Child” CPR age changed to 1 - Puberty (1-14 years at University of Utah)

►Rescue breath duration now 1 second for ALL* ages

►Rescue breathing: ▪ Adults - 1 breath/5-6 seconds

▪ Child & Infant – 1 breath/3-5 seconds
▪ Via endotracheal tube, ALL* ages – 1 breath/6-8 seconds

►Airway opening for trauma victim: ▪ Initially use jaw thrust

▪ Use head-tilt-chin lift if breaths not
effective

► Unconscious choking victim: ▪ CPR only, NO abdominal thrusts

▪ NO blind finger sweeps – ALL ages

* Does not include Newborns

2
 2005 CPR Changes continued
Advanced Cardiovascular Life Support (ACLS)
►”Effective ACLS begins with high-quality CPR” – see BLS changes above

►Defibrillation: ▪ 1 shock followed immediately by 2 minutes /5 cycles CPR

▪ No pulse check or rhythm check after shock, unless ECG
monitored by ICU personnel – limit check to < 10 seconds

►Defibrillation Dose: ▪ Monophasic device - 360 Joules for ALL shocks

▪Zoll Biphasic - 120 Joules 1st shock
150 Joules 2nd shock,
200 Joules subsequent shocks
► Drug Delivery during CPR:
▪ Minimize interruptions in compressions
▪ Remember, 2 minutes CPR immediately following shock
▪ Administer drugs after first rhythm analysis following 2
minutes of CPR in VF/VT
▪ Drug delivery should not interrupt CPR

►Endotracheal Intubation: ▪ Limited to experienced providers

▪ LMA and Combitube equivalent to bag-mask

►Confirmation of ET placement:
▪ Always use CO2 detector or Esophageal detector
▪ Detectors are now for “primary” confirmation
▪ Repeat use of detectors if patient is moved

►IV & IO medication delivery preferred over Endotracheal administration

►Vasopressin: ▪ May replace 1st or 2nd dose of Epinephrine in VF/VT

▪ Can be used in PEA or Asystole, same method as VF/VT

►Symptomatic Bradycardia: ▪ Atropine dose now 0.5 mg only

▪ Isoproterenol eliminated

►Symptomatic Tachycardia: ▪ Algorithm simplified

▪ Still cardiovert unstable patient immediately
▪ ECG narrow vs wide, then regular vs irregular

►Therapeutic Hypothermia: ▪ Possibly effective for unconscious, post-arrest

victim, with spontaneous circulation
▪ Cool to 32 – 34 C for 12-24 hours

►Acute Coronary Syndrome: ▪ EMS dispatcher may now recommend aspirin