2010 America Heart Association Guidelines for Cardiopulmonary

Resuscitation and Emergency Cardiovascular Care

Cardiopulmonary Resuscitation

50th anniversary of modern CPR

50th anniversary of modern CPR

• 1960 Kouewenhoven, Knickerbocker, Jude: documented 14 pts who survived cardiac arrest with the application of closed chest cardiac massage

• 1960 Maryland Medical Society: combination of chest compression and rescue breathing

• 1962 Direct-current, monophasic waveform defibrillation

• 1966 AHA: 1st cardiopulmonary (CPR) guidelines periodic updates

50th anniversary of modern CPR

• During 50 years: early recognition and activation, early CPR, early defibrillation, and early access to emergency medical care save hundreds of thousands of lives around the world

2010 America Heart Association Guidelines for Cardiopulmonary Resuscitation and

Emergency Cardiovascular Care

WHAT’S NEW?

Emphasis on Chest Compressions

• 2010 (New): If a bystander is not trained in CPR, the bystander should provide Hands-Only™ (compression-only) CPR for the adult victim who suddenly collapses, with an emphasis to “push hard and fast” on the center of the chest, or follow the directions of the EMS dispatcher. The rescuer should continue Hands-Only CPR until an AED arrives and is ready for use or EMS providers or other responders take over care of the victim.

• All trained lay rescuers should, at a minimum, provide chest compressions for victims of cardiac arrest. In addition, if the trained lay rescuer is able to perform rescue breaths, compressions and breaths should be provided in a ratio of 30 compressions to 2 breaths. The rescuer should continue CPR until an AED arrives and is ready for use or EMS providers take over care of the victim.

• 2005 (Old): The 2005 AHA Guidelines for CPR and ECC did not provide different recommendations for trained versus untrained rescuers but did recommend that dispatchers provide compression-only CPR instructions to untrained bystanders.

• The 2005 AHA Guidelines for CPR and ECC did note that if the rescuer was unwilling or unable to provide ventilations, the rescuer should provide chest compressions only.

Change in CPR Sequence: C-A-B Rather Than A-B-C

• 2010 (New): Initiate chest compressions before ventilations.

• 2005 (Old): The sequence of adult CPR began with opening of the airway, checking for normal breathing, and then delivery of 2 rescue breaths followed by cycles of 30 chest compressions and 2 breaths.

Elimination of “Look, Listen, and Feel for Breathing”

• 2010 (New): “Look, listen, and feel” was removed from the CPR sequence. After delivery of 30 compressions, the lone rescuer opens the victim’s airway and delivers 2 breaths.

• 2005 (Old): “Look, listen, and feel” was used to assess breathing after the airway was opened.

Chest Compression Rate: At Least 100 per Minute

• 2010 (New): It is reasonable for lay rescuers and healthcare providers to perform chest compressions at a rate of at least 100/min.

• 2005 (Old): Compress at a rate of about 100/min.

In cardiac arrest, think 'Stayin' Alive'

• Debra Bader was taking a walk in the woods with her 53-year-old husband one morning when suddenly he collapsed. At first she thought the situation was hopeless.

• "I looked at him and said, 'He's dead,' because he wasn't moving or making any sounds at all," Bader remembers. "But I pulled the cell phone out of his pocket and called 911, and then a public service announcement I'd heard on the radio popped into my head.“

• The one-minute PSA from the American Heart Association instructed listeners, in the event of cardiac arrest, to perform chest compressions very hard to the beat of the 1970s Bee Gees song "Stayin' Alive.”

July 02, 2009

Chest Compression Depth

• 2010 (New): The adult sternum should be depressed at least 2 inches (5 cm).

• 2005 (Old): The adult sternum should be depressed approximately 1½ to 2 inches (approximately 4 to 5 cm).