Part 7: Adult Advanced Cardiovascular Life Support - 2015 American Heart Association Guidelines Update

Sep 23, 2026

Adult Advanced Cardiovascular Life Support (ACLS) and post–cardiac arrest care are presented as sequential stages in cardiac arrest treatment, positioned between basic life support (BLS) and post–cardiac arrest care. ACLS training is recommended for advanced prehospital and in-hospital providers, incorporating comparisons between out-of-hospital and in-hospital arrest data. The 2015 American Heart Association Guidelines Update for CPR and Emergency Cardiovascular Care is based on an extensive ILCOR evidence review using PICO questions, GRADE domains, and structured consensus recommendations.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages22

Reading Time55 min

AccessFree to download

Introduction

Scope of ACLS within the care sequence

Evidence review methodology and recommendation development

ILCOR ACLS task force questions and guideline citation

Part 7: Adult Advanced Cardiovascular Life Support 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Mark S. Link, Chair; Lauren C. Berkow; Peter J. Kudenchuk; Henry R. Halperin; Erik P. Hess; Vivek K. Moitra; Robert W. Neumar; Brian J. O’Neil; James H. Paxton; Scott M. Silvers; Roger D. White; Demetris Yannopoulos; Michael W. Donnino Introduction Basic life support (BLS), advanced cardiovascular life support (ACLS), and post–cardiac arrest care are labels of convenience that each describe a set of skills and knowledge that are applied sequentially during the treatment of patients who have a cardiac arrest. There is overlap as each stage of care progresses to the next, but generally ACLS comprises the level of care between BLS and post–cardiac arrest care. ACLS training is recommended for advanced providers of both prehospital and in-hospital medical care. In the past, much of the data regarding resuscitation was gathered from out-of-hospital arrests, but in recent years, data have also been collected from in-hospital arrests, allowing for a comparison of cardiac arrest and resuscitation in these 2 settings. While there are many similarities, there are also some differences between in-and out-of-hospital cardiac arrest etiology, which may lead to changes in recommended resuscitation treatment or in sequencing of care. The consideration of steroid administration for in-hospital cardiac arrest (IHCA) versus out-ofhospital cardiac arrest (OHCA) is one such example discussed in this Part. The recommendations in this 2015 American Heart Association (AHA) Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) are based on an extensive evidence review process that was begun by the International Liaison Committee on Resuscitation (ILCOR) after the publication of the ILCOR 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations 1 and was completed in February 2015.2 In this in-depth evidence review process, the ILCORtask forces examined topics and then generated prioritized lists of questions for systematic review. Questions were first formulated in PICO (population, intervention, comparator, outcome) format,3 and then a search strategy and inclusion and exclusion criteria were defined and a search for relevant articles was performed. The evidence was evaluated by using the standardized methodological approach proposed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group.4 The quality of the evidence was categorized based on the study methodologies and the 5 core GRADE domains of risk of bias, inconsistency, indirectness, imprecision, and other considerations (including publication bias) . Then, where possible, consensus-based treatment recommendations were created. To create this 2015 Guidelines Update, the AHA formed 15 writing groups, with careful attention to avoid or manage conflicts of interest, to assess the ILCOR treatment recommendations and to write AHA treatment recommendations by using the AHA Class of Recommendation and Level of Evidence (LOE) system. The recommendations made in this 2015 Guidelines Update are informed by the ILCOR recommendations and GRADE classification, in the context of the delivery of medical care in North America. The AHA ACLS writing group made new recommendations only on topics specifically reviewed by ILCOR in 2015. This chapter delineates any instances where the AHA writing group developed recommendations that are substantially different than the ILCOR statements. In the online version of this document, live links are provided so the reader can connect directly to the systematic reviews on the Scientific Evidence Evaluation and Review System (SEERS) website. These links are indicated by a superscript combination of letters and numbers (eg, ALS 43

FAQs

How does ACLS fit into the overall cardiac arrest treatment sequence?

ACLS, as a label for a defined set of skills and knowledge, is generally the level of care between BLS and post–cardiac arrest care, with overlap across stages as care progresses.

What evidence process supported the 2015 AHA Guidelines Update?

The update was based on an extensive ILCOR evidence review process using prioritized PICO questions, predefined search strategies and criteria, and evaluation with the GRADE methodological approach across core risk-of-bias domains.

How were final treatment recommendations created in the 2015 update?

AHA formed 15 writing groups to assess ILCOR treatment recommendations and develop AHA recommendations using the AHA Class of Recommendation and Level of Evidence system, with consensus-based recommendations where possible.

Sep 23, 2026

Uploaded by Sophia Brooks