Medical Scientist Guides AHA’s Advanced Life Support ‘Playbook’

A University of Texas at Dallas medical scientist in the School of Behavioral and Brain Sciences (BBS) played a lead role in formulating the latest recommendations for emergency cardiovascular care used around the world.

Dr. Jane Wigginton, a board-certified physician in emergency medicine and in lifestyle medicine with more than 25 years in the emergency department at Parkland Memorial Hospital in Dallas, is the lead author of the adult Advanced Life Support (ALS) manuscript of the 2025 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The guidelines were published Oct. 22 in the AHA journal Circulation.

Comprising a dozen sections, the guidelines cover the interventions used in a wide range of emergency situations, including management of cardiac arrest and protocols for arrhythmia, pediatric resuscitation, toxicology, and training standards for physicians, nurses, paramedics and emergency responders.

The AHA’s recommendations form the basis for the education of lay rescuers and health care providers worldwide and are revised every five years to account for new research findings of the past half-decade.

“Having our university lead this publication elevates UT Dallas’ place on the international stage in clinical research. It affirms that we have many people at UT Dallas who care deeply about cardiovascular function in addition to the brain.”

Dr. Adam J. Woods, dean of the School of Behavioral and Brain Sciences

The ALS section that Wigginton oversaw covers use of defibrillation; timing of use of drugs such as epinephrine and lidocaine; airway and ventilation strategies; and identification of reversible causes of cardiac arrest.

“This is the manuscript that defines what professional rescuers do when someone’s heart stops. It is considered the clinical cornerstone of professional responder guidelines,” said Wigginton, who is chief medical officer at the Texas Biomedical Device Center; medical director and co-director of UT Dallas’ Clinical and Translational Research Center; and medical science research director at the Center for BrainHealth.

“ALS is among the most referenced, most widely used and most consequential sections in the AHA guidelines because it provides the core science and clinical algorithms that underlie the protocols for all EMS systems, emergency departments and hospital-based resuscitation teams — not just in the United States, but in many countries around the world.”

Each year, approximately 350,000 people in the U.S. experience an out-of-hospital cardiac arrest, which results in death about 90% of the time, according to the AHA. One of the updated recommendations is that first-shock attempts to restore regular heart rhythm during atrial fibrillation in adults should use higher doses of electrical energy — at least 200 joules.

Wigginton has volunteered with the AHA for 25 years and is a veteran of multiple cycles of the recommendation revision process. She said her emergency medicine experience and her research that she has continued at UT Dallas played a significant role in her appointment to the leadership position.

“While restarting spontaneous circulation was previously the gold standard for clinical trial outcomes, now people are more focused on saving the brain, so my work in that area at UT Dallas offers me extra perspective,” she said.

“This is not just a professional milestone — it is an institutional milestone,” she added. “The AHA guidelines are the playbook that determines how lives are saved in the most critical of moments. To help lead that work is both a privilege and a profound responsibility.”

In addition to Wigginton, who was vice chair of the writing group, and Dr. Michael Kurz, chief of emergency medicine at the University of Chicago and chair of the writing group, 14 others in the fields of emergency medicine, emergency medical services, cardiology, critical care, public health, nursing and education contributed to the adult ALS guidelines.

“Having our university lead this publication elevates UT Dallas’ place on the international stage in clinical research. It affirms that we have many people at UT Dallas who care deeply about cardiovascular function in addition to the brain,” said Dr. Adam J. Woods, BBS dean and the Aage and Margareta Møller Distinguished Professor in Behavioral and Brain Sciences. “The basic science leading to the clinical trials that inform this document started in labs like those at UT Dallas. Researchers should understand the impact that they have as we translate these findings into improving lifesaving treatment for people.”