Comprehensive Guide to Basic and Advanced Cardiac Life Support with 2025 AHA Updates

Comprehensive Guide to Basic and Advanced Cardiac Life Support with 2025 AHA Updates

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  08/05/2026 1 Basic lifesupport Advanced cardiac life support Dr. Amrit Baral Resident, MS-GS
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  08/05/2026 2 Objectives • ReviewBLS principles • Review ACLS algorithms • Understand 2025 AHA updates
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  08/05/2026 3 Universal Chainof Survival • Recognition & activation • High-quality CPR • Rapid defibrillation • Advanced resuscitation • Post-cardiac arrest care • Recovery
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  08/05/2026 4
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  08/05/2026 5 Recognition ofCardiac Arrest • Unresponsive • No normal breathing • No pulse within 10 seconds
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  08/05/2026 6 Adult BasicLife Support Algorithm for Lay Rescuers.
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  08/05/2026 7
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  08/05/2026 8 High-Quality CPR •Rate: 100–120/min • Depth: 5 cm (2 inch) • Full recoil in between • Minimize interruptions • Avoid excessive ventilation
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  08/05/2026 9 Adult Foreign-BodyAirway Obstruction Algorithm.
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  08/05/2026 10 Pediatric BLS •Respiratory conditions remain the major cause of cardiac arrest in infants and children • For out-of-hospital cardiac arrest (OHCA) in infants and children, providing breaths in addition to chest compressions improves survival • A respiratory rate of 20 to 30 breaths per minute • For infants with severe foreign-body airway obstruction (FBAO), repeated cycles of 5 back blows alternating with 5 chest thrusts is recommended.
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  08/05/2026 11 Pediatric BLS •Abdominal thrusts are not recommended in infants. • For children with severe FBAO, repeated cycles of 5 back blows alternating with 5 abdominal thrusts is recommended. • For infants, the recommended compression techniques include using either the 1-hand technique or the 2 thumb– encircling hands technique. • If the rescuer cannot physically encircle the chest, it is recommended to compress the chest with the heel-of-1-hand technique. • The use of 2 fingers along the sternum was eliminated due to ineffectiveness in achieving proper depth.
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  08/05/2026 12 Pediatric BLS •An automated external defibrillator (AED) should be attached as soon as possible using a pediatric attenuator and pediatric pads if available. • Prompt defibrillation for ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) is critical, with minimization of peri-shock pauses.
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  08/05/2026 13 Pediatric BLS(Infants to Puberty) for Lay Rescuers.
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  08/05/2026 14 Pediatric BLSAlgorithm (Infants to Puberty) for Health Care Professionals —Single
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  08/05/2026 15 Pediatric BLSAlgorithm (Infants to Puberty) for Health Care Professionals —2 or More Rescuers.
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  08/05/2026 16 Chest thrustsin an infant with severe foreign-body airway obstruction. Back blows in an infant with severe foreign-body airway obstruction. Abdominal thrusts in a child with severe foreign-body airway obstruction
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  08/05/2026 17 Child FBAO.
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  08/05/2026 18
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  08/05/2026 19 Chest Compression
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  08/05/2026 20 ACLS
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  08/05/2026 21 Adult CardiacArrest Algorithm.
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  08/05/2026 22 Pediatric CardiacArrest Algorithm.
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  08/05/2026 23 Post cardiacarrest care
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  08/05/2026 24 Periarrest Arrthymia •Tachyarrhymia • Bradyarrthymia
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  08/05/2026 25 Tachyarrhymia
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  08/05/2026 26 Bradyarrthmia
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  08/05/2026 27 2025 AHAupdates Chain of survival Universal chain Choking 5 back blows + 5 thrusts Infant CPR Two-finger method removed Naloxone Increased emphasis IV vs IO IV preferred first Temperature control ≥36 hours Cognitive aids Recommended
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  08/05/2026 28 High performanceteam dynamics • Clear roles and responsibilities • Knowing your limitation • Constructive intervention • Closed loop communication • Clear message • Mutual respect • Debriefing
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  08/05/2026 29 High performanceteam • Team leader • Compressor • Airway manager • Defibrillator operator • Medication nurse • Recorder
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  08/05/2026 30 High performanceteam
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  08/05/2026 31 Neurologic Prognostication •Clinical examination • EEG • CT/MRI • Biomarkers • Avoid premature withdrawal of care
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  08/05/2026 32 Neurologic Prognostication •Unconcious patient, M≤3 at 72 hours without confounder • At least two of the foolowing is associated with poor outcome  no pupillary and corneal reflex at ≥72 hours  Bilaterally absent N20 SSEP wave  Highly malignant EEG at > 24 hours  NSE > 60 ug/l at 48 and or 72 hours  Status myoclonus ≤ 72 hours  Diffuse and extensive anoxic injury on brain CT/MRI
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  08/05/2026 33 Key Messages •Early recognition • High-quality CPR • Early defibrillation • Effective team dynamics • Adherence to ACLS algorithms • Treat reversible causes • Optimize post-arrest care
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  08/05/2026 34 References • https://www.ahajournals.org/toc/circ/152/16_suppl_2