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Published by Sven Ordanza

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Published by: Sven Ordanza on May 24, 2011
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Highlights of the
 American Heart Association
Guidelines for CPR and ECC
Major Issues Affecting All Rescuers 1Lay Rescuer Adult CPR 3Healthcare Provider BLS 5Electrical Therapies 9CPR Techniques and Devices 12 Advanced CardiovascularLife Support 13 Acute Coronary Syndromes 17Stroke 18Pediatric Basic Life Support 18Pediatric Advanced LifeSupport 20Neonatal Resuscitation 22Ethical Issues 24Education, Implementation,and Teams 25First Aid 26Summary 28
© 2010 American Heart Association
Mary Fran Hazinski, RN, MSN
 Associate Editors
Leon Chameides, MDRobin Hemphill, MD, MPHRicardo A. Samson, MDStephen M. Schexnayder, MDElizabeth Sinz, MD
Brenda Schoolfield
Guidelines Writing Group Chairs and Cochairs
Michael R. Sayre, MDMarc D. Berg, MDRobert A. Berg, MDFarhan Bhanji, MDJohn E. Billi, MDClifton W. Callaway, MD, PhDDiana M. Cave, RN, MSN, CENBrett Cucchiara, MDJeffrey D. Ferguson, MD, NREMT-PRobert W. Hickey, MDEdward C. Jauch, MD, MSJohn Kattwinkel, MDMonica E. Kleinman, MDPeter J. Kudenchuk, MDMark S. Link, MDLaurie J. Morrison, MD, MScRobert W. Neumar, MD, PhDRobert E. O’Connor, MD, MPHMary Ann Peberdy, MDJeffrey M. Perlman, MB, ChBThomas D. Rea, MD, MPHMichael Shuster, MD Andrew H. Travers, MD, MScTerry L. Vanden Hoek, MD
Highlights of the 2010 AHA Guidelines for CPR and ECC
his “Guidelines Highlights” publication summarizesthe key issues and changes in the 2010 American Heart Association (AHA) Guidelines forCardiopulmonary Resuscitation (CPR) and EmergencyCardiovascular Care (ECC). It has been developed forresuscitation providers and for AHA instructors to focus onresuscitation science and guidelines recommendations thatare most important or controversial or will result in changes inresuscitation practice or resuscitation training. In addition, itprovides the rationale for the recommendations.Because this publication is designed as a summary, it doesnot reference the supporting published studies and doesnot list Classes of Recommendations or Levels of Evidence.For more detailed information and references, the reader isencouraged to read the 2010 AHA Guidelines for CPR andECC, including the Executive Summary,
published onlinein
in October 2010 and to consult the detailedsummary of resuscitation science in the 2010 InternationalConsensus on CPR and ECC Science With TreatmentRecommendations, published simultaneously in
This year marks the 50th anniversary of the first peer-reviewedmedical publication documenting survival after closedchest compression for cardiac arrest,
and resuscitationexperts and providers remain dedicated to reducing deathand disability from cardiovascular diseases and stroke.Bystanders, first responders, and healthcare providers allplay key roles in providing CPR for victims of cardiac arrest.In addition, advanced providers can provide excellentperiarrest and postarrest care.The 2010 AHA Guidelines for CPR and ECC are based onan international evidence evaluation process that involvedhundreds of international resuscitation scientists and expertswho evaluated, discussed, and debated thousands of peer-reviewed publications. Information about the 2010 evidenceevaluation process is contained in Box 1.
This section summarizes major issues in the 2010 AHAGuidelines for CPR and ECC, primarily those in basic lifesupport (BLS) that affect all rescuers, whether healthcareproviders or lay rescuers. The 2005 AHA Guidelines for CPRand ECC emphasized the importance of high-quality chestcompressions (compressing at an adequate rate and depth,allowing complete chest recoil after each compression, andminimizing interruptions in chest compressions). Studiespublished before and since 2005 have demonstrated that (1) thequality of chest compressions continues to require improvement,although implementation of the 2005 AHA Guidelines for CPRand ECC has been associated with better CPR quality andgreater survival; (2) there is considerable variation in survivalfrom out-of-hospital cardiac arrest across emergency medicalservices (EMS) systems; and (3) most victims of out-of-hospitalsudden cardiac arrest do not receive any bystander CPR. Thechanges recommended in the 2010 AHA Guidelines for CPRand ECC attempt to address these issues and also makerecommendations to improve outcome from cardiac arrestthrough a new emphasis on post–cardiac arrest care.
Continued Emphasis on High-Quality CPR
The 2010 AHA Guidelines for CPR and ECC once againemphasize the need for high-quality CPR, includingA compression rate of at least 100/min (a change from“approximately” 100/min)A compression depth of at least 2 inches (5 cm) in adultsand a compression depth of at least one third of the anterior-posterior diameter of the chest in infants and children(approximately 1.5 inches [4 cm] in infants and 2 inches[5 cm] in children). Note that the range of 1½ to 2 inches isno longer used for adults, and the absolute depth specifiedfor children and infants is deeper than in previous versions ofthe AHA Guidelines for CPR and ECC.
Evidence Evaluation Process
 The 2010 AHA Guidelines for CPR and ECC are based on an extensive review of resuscitation literature and many debates anddiscussions by international resuscitation experts and members of the AHA ECC Committee and Subcommittees. The ILCOR 2010International Consensus on CPR and ECC Science With Treatment Recommendations, simultaneously published in
summarizes the international consensus interpreting tens of thousands of peer-reviewed resuscitation studies. This2010 international evidence evaluation process involved 356 resuscitation experts from 29 countries who analyzed, discussed, anddebated the resuscitation research during in-person meetings, conference calls, and online sessions (“webinars”) over a 36-monthperiod, including the 2010 International Consensus Conference on CPR and ECC Science With Treatment Recommendations, heldin Dallas, Texas, in early 2010. Worksheet experts produced 411 scientific evidence reviews of 277 topics in resuscitation and ECC. The process included structured evidence evaluation, analysis, and cataloging of the literature. It also included rigorous disclosure andmanagement of potential conflicts of interest. The 2010 AHA Guidelines for CPR and ECC
contain the expert recommendations forapplication of the International Consensus on CPR and ECC Science With Treatment Recommendations with consideration of theireffectiveness, ease of teaching and application, and local systems factors.

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