ACLS Guidelines-CPR

High quality CPR continues to be of primary importance in optimizing outcomes.
Compression Quality
Emphasis is being placed on high quality CPR with compressions of adequate depth (2-2 1/2″) and rate, allowing complete chest recoil.
Compression Pauses
Minimization of the interval between stopping chest compressions and shock delivery should be encouaged. Data collected has indicated that minimizing the pause between compressions and shock improves the chances of shock success.


Excessive ventilation can have detrimental effects on the patient who is in cardiac arrest or other low-blood-flow states. Therefore excessive ventilation should be avoided.

CPR Sequence

It is true that the sequence of BLS steps has changed from A-B-C to C-A-B. However for ACLS in-hospital providers, the AHA states that, “it is reasonable for healthcare providers to tailor the sequence of rescue actions to the most likely cause of arrest.”

Team Delegation Emphasized

Improved outcomes for ACLS are expected when ACLS is performed by an integrated team of highly trained rescuers. Having a team of highly trained rescuers allows for efficient management of the many tasks performed by healthcare providers during a resuscitation attempt. Thus, training should focus on building the team as each member arrives or quickly delegating roles when multiple rescuers are present.

Major BLS Changes

-Encourage Hands only (compressions only) CPR for the untrained lay rescuer.
-CPR sequence changed from A-B-C to C-A-B
-depth of compressions also changed for BLS as stated above

2010 ACLS Guidelines - American Heart Classes video