The American Heart Association (AHA) published the 2018 AHA Focused Updates on Advanced Cardiovascular Life Support and Pediatric Advanced Life Support, also known as the 2018 Focused Updates. The AHA training network and volunteers were notified on November 5, 2018 of the updates.

Evidence-based Updates

The updates were published in cooperation with the International Liaison Committee on Resuscitation (ILCOR), which was formed to provide a forum for liaison between principal resuscitation organizations worldwide. The AHA expressed that their evidence-based evaluations will be more continuous, rigorous and frequent. Prior to 2017, the AHA’s comprehensive reviews and expert consensus only happened every 5 years.

The AHA published the following 6 updates:

  1. Amiodarone or lidocaine may be considered for Ventricular Fibrillation/pulseless Ventricular Tachycardia (VF/pVT) that is unresponsive to defibrillation. These drugs may be particularly useful for patients with witnessed arrest, for whom time to drug administration may be shorter.
  2. Lidocaine has been added to the ACLS Cardiac Arrest Algorithm and the ACLS Cardiac Arrest Circular Algorithm for treatment of shock-refractory VF/pVT.
  3. The routine use of Magnesium for cardiac arrest is not recommended in adult patients. Magnesium may be considered for torsades de pointes (i.e., polymorphic VT associated with long QT interval).
  4. There is insufficient evidence to support or refute the routine use of a β-blocker early (within the first hour) after return of spontaneous circulation (ROSC).
  5. There is insufficient evidence to support or refute the routine use of lidocaine early (within the first hour) after ROSC. In the absence of contraindications, the prophylactic use of lidocaine may be considered in specific circumstances (such as during emergency medical services transport) when treatment of recurrent VF/pVT might prove to be challenging.
  6. While there are no changes to the depiction of sequences and therapies from the 2015 PALS algorithm, some minor edits have been made to the PALS Cardiac Arrest Algorithm in 2018 to be consistent with language in the ACLS Cardiac Arrest Algorithm.

Information for Instructors

The 2018 focused updates have not changed any required products or materials. But instructors may practice skills using either amiodarone or lidocaine during CPR in ACLS, ACLS EP, and PALS courses, consistent with the student’s local protocol. But, skills testing procedures do not change during these circumstances.

If you are an instructor and need more information, you can visit the AHA Instructor Network for the full document, as well as relevant news and articles.

To sign up for an AHA CPR/AED/First Aid Class, visit our open enrollment calendar or call (833) 622-8633.