Editing Advanced cardiac life support (section)

== Efficacy of ACLS ==
Like a medical intervention, researchers have had to ask whether ACLS is effective. Data generally demonstrates that patients have better survival outcomes (increased ROSC, increased survival to hospital discharge and/or superior neurological outcomes) when they receive ACLS;<ref>{{Cite journal|last1=Sanders|first1=A. B.|last2=Berg|first2=R. A.|last3=Burress|first3=M.|last4=Genova|first4=R. T.|last5=Kern|first5=K. B.|last6=Ewy|first6=G. A.|date=January 1994|title=The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community|url=https://pubmed.ncbi.nlm.nih.gov/8273960/|journal=Annals of Emergency Medicine|volume=23|issue=1|pages=56–59|doi=10.1016/s0196-0644(94)70009-5|issn=0196-0644|pmid=8273960}}</ref> however a large study of [[Resuscitation Outcomes Consortium|ROC]] patients showed that this effect may only be if ACLS is delivered in the first six minutes of arrest.<ref>{{Cite journal|last1=Kurz|first1=Michael Christopher|last2=Schmicker|first2=Robert H.|last3=Leroux|first3=Brian|last4=Nichol|first4=Graham|last5=Aufderheide|first5=Tom P.|last6=Cheskes|first6=Sheldon|last7=Grunau|first7=Brian|last8=Jasti|first8=Jamie|last9=Kudenchuk|first9=Peter|last10=Vilke|first10=Gary M.|last11=Buick|first11=Jason|date=July 2018|title=Advanced vs. Basic Life Support in the Treatment of Out-of-Hospital Cardiopulmonary Arrest in the Resuscitation Outcomes Consortium|journal=Resuscitation|volume=128|pages=132–137|doi=10.1016/j.resuscitation.2018.04.031|issn=1873-1570|pmid=29723609|s2cid=19150010|doi-access=free}}</ref> This study also found that ACLS increases survival but does not produce superior neurological outcomes.

Some studies have raised concerns that ACLS education can be inconstantly or inadequately taught which can result in poor retention, leading to poor ACLS performance.<ref>{{Cite journal|last1=Kidd|first1=Tracy|last2=Kendall|first2=Sharon|date=January 2007|title=Review of effective advanced cardiac life support training using experiential learning|url=https://pubmed.ncbi.nlm.nih.gov/17181667/|journal=Journal of Clinical Nursing|volume=16|issue=1|pages=58–66|doi=10.1111/j.1365-2702.2006.01571.x|issn=0962-1067|pmid=17181667}}</ref> One study from 1998 looked at the ACLS use of epinephrine, atropine, bicarbonate, calcium, lidocaine, and bretylium in cardiac arrests and found that these medications were not associated with higher resuscitation rates.<ref>{{Cite journal|last1=van Walraven|first1=C.|last2=Stiell|first2=I. G.|last3=Wells|first3=G. A.|last4=Hébert|first4=P. C.|last5=Vandemheen|first5=K.|date=November 1998|title=Do advanced cardiac life support drugs increase resuscitation rates from in-hospital cardiac arrest? The OTAC Study Group|url=https://pubmed.ncbi.nlm.nih.gov/9795316/|journal=Annals of Emergency Medicine|volume=32|issue=5|pages=544–553|doi=10.1016/s0196-0644(98)70031-9|issn=0196-0644|pmid=9795316}}</ref>

Research on ACLS can be challenging because ACLS is a bundle of care recommendations; with each individual treatment component being profoundly consequential. There is active debate within the resuscitation research community about the value of certain interventions. Active areas of research include determining the value of vasopressors in arrests,<ref>{{Cite journal|last1=Jung|first1=Julianna|last2=Rice|first2=Julie|last3=Bord|first3=Sharon|date=December 2018|title=Rethinking the role of epinephrine in cardiac arrest: the PARAMEDIC2 trial|journal=Annals of Translational Medicine|language=en|volume=6|issue=Suppl 2|pages=S129|doi=10.21037/atm.2018.12.31|pmid=30740450|pmc=6330609 |doi-access=free }}</ref> ideal airway use<ref>{{Cite journal|last1=Carlson|first1=Jestin N.|last2=Wang|first2=Henry E.|date=October 2020|title=Optimal Airway Management in Cardiac Arrest|url=https://pubmed.ncbi.nlm.nih.gov/32892823/|journal=Critical Care Clinics|volume=36|issue=4|pages=705–714|doi=10.1016/j.ccc.2020.07.008|issn=1557-8232|pmid=32892823|s2cid=221523919}}</ref> and different waveforms for defibrillation.<ref>{{Cite journal|last1=Hagihara|first1=Akihito|last2=Onozuka|first2=Daisuke|last3=Ono|first3=Junko|last4=Nagata|first4=Takashi|last5=Hasegawa|first5=Manabu|date=January 2018|title=Interaction of defibrillation waveform with the time to defibrillation or the number of defibrillation attempts on survival from out-of-hospital cardiac arrest|url=https://pubmed.ncbi.nlm.nih.gov/29175354/|journal=Resuscitation|volume=122|pages=54–60|doi=10.1016/j.resuscitation.2017.11.053|issn=1873-1570|pmid=29175354}}</ref>