2010 CPR Guidelines

How the American Heart Association's CPR Guidelines Have Changed for 2010
By Rod Brouhard, About.com Guide Updated October 18, 2010
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Sponsored Links ACLS CourseAHA certified ACLS course in Singapore.firstaidtraining.com.sg/aha ODG TreatmentAuthorized treatment/UR guidelines for workers' comp medical carewww.worklossdata.com CPR mouth to mouth MaskEMSS-Medical Solutions(OEM) T:86-2161020118export@emsscn.comwww.Emssn.com Sponsored Links Heart attackLearn more about Heart Attack and thrombosis! Visit ThrombosisAdviserwww.Thrombosisadviser.com ACOEM Practice GuidelinesEvidence based recommendations, musculoskeletal injuries, disordersapg-i.acoem.org After a review of the available research published over a 5 year period, the American Heart Association released its 2010 CPR Guidelines. As expected, the focus for CPR is on good quality chest compressions. Here are the differences between the 2005 and the 2010 CPR Guidelines:

A-B-C is for babies; now it's C-A-B! It used to be follow your ABC's: airway, breathing and chest compressions. Now, Compressions come first, only then do you focus on Airway and Breathing. The only exception to the rule will be newborn babies, but everyone else -- whether it's infant CPR, child CPR or adult CPR -- will get chest compressions before you worry about the airway. Why did CPR change from A-B-C to C-A-B? No more looking, listening and feeling. The key to saving a cardiac arrest victim is action, not assessment. Call 911 the moment you realize the victim won't wake up and doesn't seem to be breathing right. Trust your gut. If you have to hold your cheek over the victim's mouth and carefully try to detect a puff of air, it's a pretty good bet she's not breathing very well, if at all. I have a secret to share: paramedics have been doing it this way for years. Rarely have I seen an EMT or a paramedic put her ear to a victim's nose and listen for air movement. We just get to work.

Push a little harder. How deep you should push on the chest has changed for adult CPR. It was 1 1/2 to 2 inches, but now the Heart Association wants you to push at least 2 inches deep on the chest. Push a little faster. AHA changed the wording here, too. Instead of pushing on the chest at about 100 compressions per minute, AHA wants you to push at least 100 compressions per minute. At that rate, 30 compressions should take you 18 seconds. Besides the changes under the 2010 CPR Guidelines, AHA continues to emphasize some important points:

Hands Only CPR. This is technically a change from the 2005 Guidelines, but AHA endorsed this form of CPR in 2008. The Heart Association still wants untrained lay rescuers to do Hands Only CPR on adult victims who collapse in front of them. My biggest problem with this campaign is what's left unsaid. What does AHA want untrained lay rescuers to do with all the other victims? In other words, what do you do with the victims that aren't adults or that didn't collapse right in front of you? AHA doesn't provide an answer, but I have a suggestion: Do Hands Only CPR, because doing something is always better than doing nothing. Recognize sudden cardiac arrest. CPR is the only treatment for sudden cardiac arrest and AHA wants you to notice when it happens. Don't stop pushing. Every interruption in chest compressions interrupts blood flow to the brain, which leads to brain death if the blood flow stops too long. It takes several chest compressions to get blood moving again. AHA wants you to keep pushing as long as you can. Push until the AED is in place and ready to analyze the heart. When it is time to do mouth to mouth, do it quick and get right back on the chest.
Source:

Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, Samson RA, Kattwinkel J, Berg RA, Bhanji F, Cave DM, Jauch EC, Kudenchuk PJ, Neumar RW, Peberdy MA, Perlman JM, Sinz E, Travers AH, Berg MD, Billi JE, Eigel B, Hickey RW, Kleinman ME, Link MS, Morrison LJ, OConnor RE, Shuster M, Callaway CW, Cucchiara B, Ferguson JD, Rea TD, Vanden Hoek TL. "Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Circulation. 2010;122(suppl 3):S640S656.

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New CPR Guidelines 2010 Vs CPR Guidelines 2005

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The American Heart Association or AHA has published its Cardiopulmonary Resuscitation(CPR) and Emergency Cardiovascular Care guidance. The new CPR guideline in this publication has few differences from the last 2005 CPR guidelines. Experts and medical professionals continuously evaluate CPR and publish its finding every 5 years. This evaluation is conducted in full including CPR steps priority adjusted with the latest medical information available to identify the most important factor in preserving patients life. The best results from these evaluations are then used to recommend the best technique and intervention for CPR procedures. The end goal of the guideline is to reduce morbidity and mortality due to emergency events by making treatment recommendations based on an analysis of the scientific evidence that answers the following questions: In which emergency conditions can morbidity or mortality be reduced by the intervention of a first aid provider? How strong is the scientific evidence that interventions performed by a first aid provider are safe, effective, and feasible? The main differences between this new CPR guideline and the 2005 CPR guidelines are. ABC instead of ACB

The New CPR has some imrpovement over the 2005 CPR - Image by stuttermonkey

In 2005 CPR guidelines the first aid steps were ABC or Airway, Breathing and Chest Compressions. This translates into opening the airway, give artificial respiration and then pressing the chess to encourage breathing. In 2010 CPR guidelines the first step would be to do the chest compressions and then focus on opening the airway and breathing. This excludes performing CPR on new born

baby or victims that you know for sure are suffering from respiratory arrest such as drugs overdose, head injury, anaesthesia, tetanus, or drowning. No More Looking Listening and Feeling The key to prevent chest discomfort becoming lethal is to act and not to observe. It is very difficult, even for the healthcare professional, to differentiate chest discomfort of cardiac origin from other chest discomfort. All chest discomforts should be assumed cardiac until proven otherwise You need to call 911 as soon as you the victim fainted or not breathing properly. Trust your guts. You may try to put your hands next to the victim mouth to feel the breath, however, looking listening and feeling does nothing to help the victim. Deeper and Faster Chest Compression The 2005 CPR guideline stated that you need to press the chest as deep as 1.5 to 2 inches with around 100 compressions per minutes. The new CPR guideline recommends pressing the chest at least 2 inches deep with at least 100 compressions per minutes or around 30 compressions for every 18 seconds. Continuous Chest Compression Every time you stop the compression you effectively cut off the blood flow to the victims brain. Prolonged absent of blood in the brain can cause brain tissues to die and permanent brain damage. It will take few compressions for the blood to flow again. It is therefore recommended that you continue to perform chest compressions until trained medical personnel can observe the situation or has defibrillator ready to take over. If you need to do mouth to mouth resuscitation, do it quick and continue performing chest compressions. However, for what the guideliness actually recommend see the next point. Compression only For untrained personnel, AHA recommends performing compression only CPR i.e. without the mouth to mouth resuscitation or artificial respiration. The reason is that for untrained rescuer, it is easier to perform and instructions are easier to give over the phone. Compression only CPR also has higher success rate than standard CPR CPR is often severely misrepresented in movies and television as being highly effective in resuscitating a person who is not breathing and has no circulation. This gives members of the public an unrealistic expectation of a successful outcome of CPR procedure. However, while CPR is unlikely to prevent cardiac arrest, it is the only way to keep the blood flow at least partially to continue to circulate to the victim brain and prevent permanent brain damage. It is paramount that you perform CPR immediately as soon as you see the sign of problems.

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