As happens every five years, the American Heart Association’s (AHA) Emergency Cardiovascular Care Committee and the International Liaison Committee on Resuscitation (ILCOR) have announced updated recommended guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC).
There were no major changes for out of hospital cardiac arrest procedures from the last guidelines update in 2010 , but there are some tweaks to the basic processes used for CPR. The “Chain of Survival” is still the same: call for help (EMS, 9-1-1); immediately begin CPR with effective chest compressions; rapid defibrillation (AED); effective advanced life support; and integrated post-cardiac arrest care. There are, however, more detailed instructions added to chest compressions.
CPR should now consist of chest compression rates between 100 and 120 compressions per minute, instead of the prior recommendation of more than 100. Studies have shown compressions faster than 120 per minute results in inadequate compression depth, and also leads to poor compression quality due to fatigue. A faster rate also does not allow for the chest to completely rebound, which is necessary to allow the heart to fill with a sufficient amount of blood for subsequent compressions.
Another recommendation change involves chest compression depth. Previously, the guidelines called for compression depth of two inches or more. The new guidelines now recommend a depth of two inches but no more than 2.4 inches. This will help to eliminate potential harm from internal injuries. However, the committee does recognize this may be hard to gauge without live feedback or CPR assist devices.
It is also strongly recommended to minimize pauses in chest compressions. Pre-shock or post-shock pauses should be as short as possible within the shock process, but more importantly pausing to deliver rescue breaths can be eliminated with “hands-only” CPR. Pausing chest compressions results in having to “prime the pump” (heart) with blood, delaying getting this precious resource to the body’s organs.
There are also updates to processes and procedures for emergency medical and hospital staff, but for those of us who are potential first responders, these are the guidelines updates which matter most. For further information, you can read the new guidelines here.
Since these guidelines updates have just been announced, it will take a few months for the AHA to publish and print new instruction materials. As soon as they are available, we’ll have them at AED Superstore!