AMERICAN HEART

ASSOCIATION

CHANGES IN THE 2010

GUIDELINES AFFECTING
ALL RESCUERS
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Health Care Provider*
PUSH HARD AND PUSH FAST

At least 100 COMPRESSIONS / MINUTE*

Allow the chest to recoil -- equal compression and relaxation times

<10 seconds for pulse checks or rescue breaths

Compression Depth*
Adults 2

Child/Infant 1/3 depth of chest 1.5" infant 2" child

Avoid excessive ventilations

AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
A-B-C changed to C-A-B*
Critical element is chest compressions
Delay in A-B

Avoidance of A & B

Early defib

If alone--call and retrieve AED

Exception asphyxial arrest
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES

Cricoid pressure not recommended

Advanced airway = 1 every 6-8 seconds

Adult: 1 every 5-6 Peds: 1 every 3

With advanced airway- no pause

 Dispatcher Identification
SCA = seizure & agonal gasps
Trained to ID ask if breathing is
normal
Only gasping???
Provide CPR instructions
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES

AHA ECC Adult Chain of Survival - New

AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Lay Rescuer Hands-only CPR (untrained vs trained)

Easier

Guided by dispatchers

SR are same
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES

Simplified Universal
BLS algorithm
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Electrical Therapies
Shock first vs CPR first
No precordial thump
CPR devices no data for
AED in hospital (goal to shock =< 3 mins)
Use in infants (with or without attenuator)
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
ACLS
Simplified algorithm
Optimized CPR quality with monitoring
Waveform capnography (>12 mmHg)
Atropine deleted (PEA/Asystole)
Chronotropic drugs for brady, then pacing
Adenosine safe for monomorphic wide tachs
Post-cardiac arrest
AMERICAN HEART ASSOCIATION
CAPNOGRAPHY
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Post-Cardiac Arrest ROSC
Therapeutic Hypothermia
Remain comatose

32-34 degree C (all ages) (89.6-93.2 F)

12-24 hours

PCI

O2 sat 94% & PETCO 35-40

AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Special Resuscitation Situations
Asthma Hypothermia

Anaphylaxis Avalanche

Pregnancy Drowning
Electric shock/lightening
Morbid obesity
PCI
PE
Cardiac tamponade
Electrolyte imbalance
Cardiac surgery
Toxins
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Acute Coronary Syndromes
Out of hospital 12-lead
Triage to PCI
Oxygen > 94 % is the goal (capno)
Morphine use with caution in UA/non-STEMI
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Stroke
Stroke-prepared hospitals

Triage to stroke centers

TPA up to 4.5 hours

AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Learning to Mastery

New CPR Prompts devices

Online training: http://www.onlineaha.org/

Instructor network
http://ahainstructornetwork.americanheart.org/AHAECC/ecc.jsp?pid=ahaecc.signin&_requestid=133687