AHA Key Changes to CPR and BLS 2010 Guidlines

This blog is taken directly from the American Heart Association and inserted here for educational purposes.
Stat Life Medical Training conducts CPR and BLS classes in Jacksonville and Orange Park

Basic Life Support

BLS is the foundation for saving lives following cardiac arrest. Fundamental aspects of adult BLS include immediate recognition of sudden cardiac arrest and activation of the emergency response system, early performance of high-quality CPR, and rapid defibrillation when appropriate. The 2010 AHA Guidelines for CPR and ECC contain several important
changes but also have areas of continued emphasis based on evidence presented in prior years.

Key Changes in the 2010 AHA Guidelines for CPR and ECC

The BLS algorithm has been simplified, and “Look, Listen and Feel” has been removed from the algorithm. Performance of these steps is inconsistent and time consuming. For this reason the 2010 AHA Guidelines for CPR and ECC stress immediate activation of the emergency response system and starting chest compressions for any unresponsive adult victim with no breathing or no normal breathing (ie, only gasps).

Encourage Hands-Only (compression only) CPR for the untrained lay rescuer. Hands-Only CPR is easier to perform by those with no training and can be more readily guided by dispatchers over the telephone.

Initiate chest compressions before giving rescue breaths (C-A-B rather than A-B-C). Chest compressions can be started immediately, whereas positioning the head, attaining a seal for mouth-to-mouth rescue breathing, or obtaining or assembling a bag-mask device for rescue breathing all take time. Beginning CPR with 30 compressions rather than 2 ventilations leads to a shorter delay to first compression.

There is an increased focus on methods to ensure that high-quality CPR is performed. Adequate chest compressions require that compressions be provided at the appropriate depth and rate, allowing complete recoil of the chest after each compression and an emphasis on minimizing any pauses in compressions and avoiding excessive ventilation. Training should focus on ensuring that chest compressions are performed correctly. The recommended depth of compression for adult victims has increased from a depth of 1½ to 2 inches to a depth of at least 2 inches.

Many tasks performed by healthcare providers during resuscitation attempts, such as chest compressions, airway management, rescue breathing, rhythm detection, shock delivery, and drug administration (if appropriate), can be performed concurrently by an integrated team of highly trained rescuers in appropriate settings. Some resuscitations start with a lone rescuer who calls for help, resulting in the arrival of additional team members. Healthcare provider training should focus on building the team as each member arrives or quickly delegating roles if multiple rescuers are present. As additional personnel arrive, responsibilities for tasks that would ordinarily be performed sequentially by fewer rescuers may now be delegated to a team of providers who should perform them simultaneously.

Key Points of Continued Emphasis for the 2010 AHA Guidelines for CPR and ECC

Early recognition of sudden cardiac arrest in adults is based on assessing responsiveness and the absence of normal breathing. Victims of cardiac arrest may initially have gasping respirations or even appear to be having a seizure. These atypical presentations may confuse a rescuer, causing a delay in calling for help or beginning CPR. Training should focus on alerting potential rescuers to the unusual presentations of sudden cardiac arrest.

Minimize interruptions in effective chest compressions until ROSC or termination of resuscitative efforts. Any unnecessary interruptions in chest compressions (including longer than necessary pauses for rescue breathing) decreases CPR effectiveness.

Minimize the importance of pulse checks by healthcare providers. Detection of a pulse can be difficult, and even highly trained healthcare providers often incorrectly assess the presence or absence of a pulse when blood pressure is abnormally low or absent. Healthcare providers should take no more than 10 seconds to determine if a pulse is present. Chest compressions delivered to patients subsequently found not to be in cardiac arrest rarely lead to significant injury.110 The lay rescuer should activate the emergency response system if he or she finds an unresponsive adult. The lay rescuer should not attempt to check for a pulse and should assume that cardiac arrest is present if an adult suddenly collapses, is unresponsive, and is not breathing or not breathing normally (ie, only gasping).

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