• Brandon Giberson, Amy Uber, F Gaieski David D Department of Emergency Medicine, Hospital of University of Pennsylvania, Philadelphia, PA, USA., Joseph B Miller, Charles Wira, Katherine Berg, Tyler Giberson, Michael N Cocchi, S Abella Benjamin B Department of Emergency Medicine, Hospital of University of Pennsylvania, Philadelphia, PA, USA., and Michael W Donnino.
• Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
• J Intensive Care Med. 2016 Sep 1; 31 (8): 537-43.

BackgroundHealth care providers nationwide are routinely trained in Advanced Cardiac Life Support (ACLS), an American Heart Association program that teaches cardiac arrest management. Recent changes in the ACLS approach have de-emphasized routine pulse checks in an effort to promote uninterrupted chest compressions. We hypothesized that this new ACLS algorithm may lead to uncertainty regarding the appropriate action following detection of a pulse during a cardiac arrest.MethodsWe conducted an observational study in which a Web-based survey was sent to ACLS-trained medical providers at 4 major urban tertiary care centers in the United States. The survey consisted of 5 multiple-choice, scenario-based ACLS questions, including our question of interest. Adult staff members with a valid ACLS certification were included.ResultsA total of 347 surveys were analyzed. The response rate was 28.1%. The majority (53.6%) of responders were between 18 and 32 years old, and 59.9% were female. The majority (54.2%) of responders incorrectly stated that they would continue CPR and possibly administer additional therapies when a team member detects a pulse immediately following defibrillation. Secondarily, only 51.9% of respondents correctly chose to perform a rhythm check following 2 minutes of CPR. The other 3 survey questions were correctly answered an average of 89.1% of the time.ConclusionConfusion exists regarding whether or not CPR and cardiac medications should be continued in the presence of a pulse. Education may be warranted to emphasize avoiding compressions and medications when a palpable pulse is detected.© The Author(s) 2014.

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