ACLS Course- and Manual-Update Content Through 2026
The most recent AHA Adult Advanced Life Support (ACLS/ALS) recommendations remain the 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, published for training implementation in late 2025. [1] The changes issued in 2026 are courseware/manual updates tied to the 2025 guidelines (not a separate “2026 ACLS guideline publication”). [1][2][3]
Scope of 2026 Updates
The AHA issued ACLS Provider Manual and ACLS Instructor Manual “Change Notice” documents that describe discrete content edits to existing training materials. [2][3] Updates were posted as updated February 6, 2026 in both change-notice documents. [2][3]
Key 2026 ACLS Provider Manual Edits
- Durable LVAD algorithm—PETCO2 threshold use clarification: PETCO2 >20 mm Hg is specified to be used only when ventilation occurs with an endotracheal tube (ETT) or tracheostomy, because supraglottic airway use (eg, King) can produce falsely elevated PETCO2 values. [2]
- Adult cardiac arrest circular algorithm—advanced airway ventilation bullet deletion: A bullet that specified once advanced airway is in place to give 1 breath every 6 seconds (10 breaths/min) with continuous chest compressions was removed from the “Adult Cardiac Arrest” circular algorithm’s Advanced Airway cell. [2]
- Science summary table—antithrombotic wording removal: The science summary table entry for AC S row bullets removed text describing clopidogrel as the primary anticoagulant/antiplatelet. [2]
- High-performance teams respiratory arrest—wording correction: A text string in the “Respiratory Arrest” section changed “risk” to “rise.” [2]
- Post–cardiac arrest care neuroprognostication—EEG spelling terminology correction: “electrocardiogram” was corrected to “electroencephalogram.” [2]
- Adult bradycardia with pulse algorithm—vascular access step added: A bullet was added to include establishing vascular access in the “Assessment and support” list for adult bradycardia with a pulse. [2]
- Post–cardiac arrest care hypotension target wording: The hypotension target was specified as Target MAP ≥65 mm Hg (replacing a previous text form). [2]
Key 2026 ACLS Instructor Manual Edits
- Durable LVAD algorithm—PETCO2 threshold use clarification: The instructor manual mirrors the provider manual clarification that PETCO2 >20 mm Hg is used only with ETT or tracheostomy and not with supraglottic airways due to falsely elevated PETCO2 risk. [3]
- Adult cardiac arrest learning station checklist—route/navigation text edits: Checklist navigation text was adjusted by deleting the instruction containing “or 7” in a pathway statement (changing “Go to 5 or 7” to “Go to 5”). [3]
- Adult cardiac arrest learning station checklist—pathway number deletion: The final gray box instruction changed from referencing “or 11” to referencing “10.” [3]
- Adult cardiac arrest learning station checklist—CPR quality bullet formatting: The “Push fast: 100–120/min” statement was separated into a distinct bullet under CPR quality. [3]
- Adult cardiac arrest learning station checklist—advanced airway ventilation bullet addition: A new bullet was added to specify if an advanced airway is in place, give 1 breath every 6 seconds (10 breaths/min) with continuous chest compressions. [3]
- Case/scenario text edits (instructional content): A scenario medication wording was changed from nitrogen to nitroglycerin in an initial information bullet. [3]
Implementation Considerations for 2026 Updates
The ACLS course materials referenced in the 2026 change notices are explicitly labeled as updates to the ACLS Provider Manual and ACLS Instructor Manual products tied to the 2025 guideline science. [2][3] The AHA Adult Advanced Life Support (Part 9) content is described as 2025 ALS guidelines within the AHA CPR/ECC guideline materials. [1]
Practical Use of 2026 Updates in Training
Training staff should align the ACLS provider and instructor materials with the enumerated edits in the Feb 6, 2026 change-notice documents when using prior-course print or eBook versions. [2][3] The specific clinical algorithm edits emphasize airway/ventilation context for PETCO2 interpretation in durable LVAD scenarios and instructional checklist wording affecting CPR quality and advanced airway ventilation timing. [2][3]