ACLS Review - 2015 Guidelines - BLS CPR and Advanced Cardiac Life Support Algorithms

Sep 23, 2026

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2015 ACLS guidelines review focusing on BLS CPR and core emergency algorithms for adult arrhythmia management. Covers the 2015 switch from ABC to CAB, pulse check within 10 seconds, rapid initiation of compressions, 30:2 ventilation ratio, and high-quality CPR targets including compression rate, minimal pauses, depth, CCF, early defibrillation with AED pads, and airway/ventilation monitoring with capnography and oximetry thresholds. Includes management pathways for sinus bradycardia, heart blocks, SVT with adenosine or cardioversion, VT with pulse stability decisions, torsades treated as VFib, and VFib workflow emphasizing immediate 200J shocks and resumption of compressions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

BLS CPR 2015 Changes

CAB approach and 30:2 ratio

High quality CPR targets

AED steps

Airway and Ventilation Monitoring

Pulse oximetry and capnography targets

Bag valve mask and advanced airway ventilation

Bradycardia and Heart Blocks

Sinus bradycardia stability assessment

Atropine dosing and escalation

Heart block management

Tachyarrhythmias: SVT, VT, and VFib

Supraventricular tachycardia

Monomorphic ventricular tachycardia

Polymorphic ventricular tachycardia and torsades

Ventricular fibrillation workflow

ACLS Review – 2015 Guidelines BLS CPR BLS CPR changes 2015. The primary change is from the “ABC” format to “CAB.” After establishing unresponsiveness and calling for a code, check for a pulse less than 10 seconds then begin compressions immediately, within 10 seconds of arriving at the patient’s side. After thirty compressions, give your first two breaths. The 30:2 ratio then will continue. Here are the basic steps in BLS: 1. Check for responsiveness 2. Call for help and an AED 3. Check for pulse and simultaneously scan the chest for breathing. 4. Begin the thirty compressions (within 10 seconds of arriving at the patient) 5. Give two breaths—continue 30:2 ratio. High Quality CPR includes: 1. Effective compressions at least 100/min, no more than 120/min 2. Minimal interruptions (<10secs) 3. Allow for recoil, monitoring via capnography *less than 10 is ineffective 4. At least 2 inch compression depth 5. Rotate q2mins/5cycles 6. Chest Compression Fraction (CCF) at least 60%, goal of greater than 80% Defibrillate early (use AED) 1. Turn on AED 2. Place AED Pads 3. Analyze Rhythm 4. Consider Compressions to prep the tissue 5. Defibrillate ‐ SHOCK Airway Pulse Oximetry to be between 94 – 99% to avoid hyperoxia (high oxygen tension can lead to tissue death Waveform Capnography (pETCO2) Best way to evaluate advanced airway placement Can assist in measuring cardiac output during CPR ETCO2 reading must be greater than 10 during CPR (>10) or patient will not survive Normal readings for pETCO2 for patients should be 35‐40 Ventilations with Bag Valve Mask (BVM)– breaths every 6 sec (10 breaths per minute) Ventilations with Advanced Airway – breaths every 6 sec (10 breaths per minute) Sinus Bradycardia (Sinus rhythm with a rate less than 50) Is your patient stable or unstable? Stable‐ monitor closely Unstable/ Symptomatic – this patient is showing signs of poor perfusion (their heart rate is not fast enough to deliver an adequate volume of blood to the body and requires treatment/ intervention) for example: hypotensive feels faint, decreased or altered mental status, cool or clammy/diaphoretic. Administer 0.5mg Atropine. If Atropine is ineffective you now have four options: 1. Repeat Atropine 0.5 mg (dosing 0.5mg – 1 mg, max total dose 3mg) 2. administer Dopamine 2‐20 mcg/kg/minute OR 3. Administer Epinephrine infusion: 2 – 10 mcg per minute 4. Prepare and provide external transcutaneous pacing. Heart Blocks Is your patient stable or unstable? Stable‐ monitor closely, seek expert consultation Unstable/ Symptomatic – this patient is showing signs of poor perfusion (their heart rate is not fast enough to deliver an adequate volume of blood to the body and requires treatment/ intervention) for example: low B/P, feels faint, decreased or altered mental status, cool or clammy/diaphoretic Administer 0.5mg Atropine. But don’t rely on atropine in Mobitz type II, second‐degree block or third‐ degree block with a new wide QRS complex. For an unstable Mobitz type II second‐degree or third‐degree heart block patient be prepared for transcutaneous pacing Supraventricular Tachycardia ‐ SVT (SUSTAINED rapid narrow complex tachycardia with a rate greater than 150) Is your patient stable or unstable? Stable‐ Attempt vagal maneuvers If vagal maneuvers aren’t successful in slowing their heart rate, administer 6 mg of Adenosine. Adenosine is that it is a fast‐push and fast‐acting drug. It may cause a short period of asystole. Patient also must be monitored. If the first dose of 6 mg isn’t successful, ACLS allow you to repeat the Adenosine providing 12 mg the second time if needed. SVT (continued) Unstable/ Symptomatic – this patient is showing signs of poor perfusion (low B/P, feels faint, decreased or altered mental status, cool or clammy/diaphoretic) it may be due to their heart rate is too fast to deliver an adequate volume of blood to the body and requi

FAQs

What is the key BLS CPR change in 2015 ACLS guidelines regarding ABC vs CAB?

The primary change moves from ABC to CAB. After unresponsiveness and calling for a code, check for pulse for less than 10 seconds, then begin compressions immediately within 10 seconds of reaching the patient.

What targets define high-quality CPR in this 2015 review?

Compressions should be at least 100/min and no more than 120/min with minimal interruptions under 10 seconds. Compression depth should be at least 2 inches and Chest Compression Fraction (CCF) at least 60% with a goal greater than 80%.

How should an unstable monomorphic VT rhythm be treated if the patient has a pulse?

If a pulse is present and the patient is unstable, deliver immediate synchronized cardioversion at 100J (or higher), then evaluate rhythm and consider a second attempt at higher energy if needed.

Sep 23, 2026

Uploaded by 404brain