In December 2005, American Heart Association released updated guidelines to Emergency Cardiac Care. The guideline change applies to both CPR and Automated External Defibrillators.

Summary: High-quality CPR with fewer interruptions is the goal of this update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care. Focusing on the value of quality CPR in saving lives when hearts are stopped, a consortium of experts recommended simplifying and streamlining the guidelines for CPR. The biggest change is increasing to 30 the number of chest compressions given for every two rescue breathes for cardiac arrest victims.

Why it’s important: Experts in resuscitation are concerned that the overall cardiac arrest survival rate has not changed significantly in the past decade, according to Mary Fran Hazinski RN, MSN, clinical nurse specialist in pediatric emergency and critical care at Vanderbilt University and the AHA Emergency Cardiovascular Care Senior Science Editor. However, immediate bystander CPR can double or triple a cardiac arrest victim’s chances of survival. Michael Sayre, MD, associate professor of emergency medicine at Ohio State University School of Medicine in Columbus and a member of the AHA’s Emergency Cardiovascular Care committee said, “The most common reason that many people die is because none of the people nearby knew CPR, and if they knew it, they didn’t do it. One of the reasons is that the skill has been too complicated. These guidelines simplify the instructions and make them easier to remember.”

What was found: Streamlining CPR for the lay person who witnesses someone suffering a cardiac arrest promises to save lives. “We eliminated some steps,” said Dr Sayre. “One is that if someone encounters a person who cannot be awakened and is not breathing, he or she should assume that the person is in cardiac arrest. They should give two breaths and move right into giving chest compressions without wasting any more time evaluating the victim. We hope that this change will help make it easier for rescuers to remember and act on the steps of CPR.” The other major change for bystanders is to increase to 30 the number of chest compressions given before pausing to give two rescue breathes, for 5 cycles or 2 minutes of CPR. This change applies to victims of all ages (except newborn infants) and is even recommended for healthcare professionals who might be working on their own before additional help arrives.

The emphasis on providing high quality CPR with fewer interruptions is also reflected in the changes to the new guidelines for using a defibrillator. For example, rescuers are advised to use only one shock before resuming CPR, rather than three, as previously recommended. Robert O’Connor, MD, director of education and research at Christiana Care Health System in Newark, Delaware, and vice chair of the AHA Emergency Cardiovascular Care Committee, said the change was made because the benefit of the additional shocks was questionable. “Most patients who are successfully converted (their hearts resume a normal rhythm) by today’s defibrillators are converted after only one shock. Those who do not convert with the first shock will have a better chance of responding to another shock if they first receive some CPR. This also reduces the length of time that the victim is left with no blood flow to the heart, brain and other vital organs.” “Advanced cardiac life support providers will need to be attentive to providing CPR during defibrillation, intubation and delivery of medications,” said. Dr O’Connor. “There will have to be careful choreography by the advanced care providers to ensure minimal interruption of CPR during advanced care procedures. But my overarching interpretation of the new guidelines is that they strengthen the chain of survival by giving patients a higher likelihood of receiving earlier CPR, earlier defibrillation and more effective advanced care.”

Please call ICE Safety Solutions at 1.877.743.8423 with support in updating or purchasing AEDs to meet the current ECC 2005 Guidelines or with training your staff under the new 2005 guidelines.