American Heart Association Updates CPR Guidelines

The American Heart Association on Monday announced "dramatic changes" to its CPR recommendations to make instructions "simpler and less intimidating to a passerby thrust into the role of rescuer," USA Today reports (Davis, USA Today, 11/29). More than 300,000 Americans die from cardiac arrest each year, and effective CPR increases a person's chance of survival twofold, according to the AP/Wall Street Journal (AP/Wall Street Journal, 11/29).

An international team of heart specialists reviewed thousands of studies on cardiac arrest and resuscitation and found that CPR instructions were too difficult for the average person to follow (USA Today, 11/29). The new guidelines change the focus of CPR instructions from mouth-to-mouth breathing to chest compressions.

According to the Boston Globe, the largest change in the recommendations calls for rescuers to provide 30 chest compressions for every two breaths administered to a victim. AHA previously recommended 15 chest compressions for every two breaths.

In addition, the new recommendations state that it is acceptable for emergency 911 operators to provide instructions for chest compressions without any breaths. Emergency rescue specialists have expressed concern that CPR often goes unadministered in part because bystanders "are reluctant to perform mouth-to-mouth resuscitation," the Globe reports.

The guidelines also recommend that rescuers "push hard, push fast" because studies show that deeper compressions are most effective. The guidelines also were changed so that they no longer vary according to the age of the person with cardiac arrest (Smith, Boston Globe, 11/29).

The recommendations are published in the journal Circulation.

AHA also recommends that:

• 911 operators be trained to give the new, simplified CPR instructions (USA Today, 11/29).
  


• Rescuers not be instructed to pause CPR in order to check for a pulse (Boston Globe, 11/29).
  


• Cities deploy more automated external defibrillators in public places, and emergency systems measure their effectiveness in saving cardiac arrest patients (USA Today, 11/29).
  


• Rescuers with defibrillators be advised to administer a single shock followed by two minutes of CPR before giving another shock if necessary. Previous guidelines called for three successive shocks (Boston Globe, 11/29).
  


• The number of Americans trained in CPR annually increase from about 9 million to 20 million (AP/Wall Street Journal, 11/29).

Michael Sayre of Ohio State University, one of the authors of the new guidelines, said, "The most common reason many people die is because no one nearby knew CPR, or if they did know it, they didn't actually do it." Sayre added, "The more times a person pushes on the chest, the better off the patient is, because there is more blood flow to the brain and other vital organs" (USA Today, 11/29).

Monica Kleinman, chair of the Emergency Cardiovascular Care Committee of AHA's Massachusetts and Rhode Island region, said, "[W]e're very much emphasizing the basics, something that any person can do. Anybody can learn how to do CPR, and it turns out to be really important to the outcome of these patients" (Boston Globe, 11/29).