Saturday, November 6, 2010

American Heart Association CPR Guidelines

From: http://emedicine.medscape.com/article/1344081-treatment

In 2010, the American Heart Association (AHA) Emergency Cardiovascular Care Committee (ECC) released their newest set of guidelines for CPR. AHA CPR 2010 guideline changes include the following:13,27
Initial sequence of steps changed from "A-B-C" (airway, breathing, chest compressions) to "C-A-B" (chest compressions, airway, breathing) except for newborns.
Look, listen, and feel is no longer recommended.
Compression depth for adults should be at least 2 inches (instead of up to 2 inches).
Compression rate should be at least 100 per minute.
Emergency cardiac treatments no longer recommended include routine atropine for pulseless electrical activity/asystole, cricoid pressure (with CPR), and airway suctioning for all newborns (exception for those with obvious obstruction).
Postcardiac arrest care is a new section included in the 2010 guidelines.28
Several recent studies have looked at the quality of CPR being performed in hospitals and by EMS systems. Findings showed that providers often did not perform CPR up to the standards of the ECC guidelines.24,29,17,30 Specifically, they found that providers were often deficient in both rate and depth of chest compressions and often provided ventilations at too high a rate. Other studies have demonstrated the impact of inadequate rate and depth on survival.31 The 2010 AHA guidelines state that untrained bystanders should perform compression-only CPR (previous AHA guidelines did not address untrained bystanders separately).4 Several studies have concluded that stopping compressions in order to give ventilations may be detrimental to the patient's outcome.32,33,34 While a bystander halts compressions to give 2 breaths, blood flow also stops and leads to a quick drop in the blood pressure that had been built up during the previous set of compressions.35