The American Heart Association is re-arranging the ABCs of cardiopulmonary resuscitation (CPR) in its 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Recommending that chest compressions be the first step for lay and professional rescuers to revive victims of sudden cardiac arrest, the association said the A-B-Cs (Airway-Breathing-Compressions) of CPR should now be changed to C-A-B (Compressions-Airway-Breathing).
In previous guidelines, the association recommended looking, listening and feeling for normal breathing before starting CPR. Now, compressions should be started immediately on anyone who is unresponsive and not breathing normally.
All victims in cardiac arrest need chest compressions. In the first few minutes of a cardiac arrest, victims will have oxygen remaining in their lungs and bloodstream, so starting CPR with chest compressions can pump that blood to the victim’s brain and heart sooner. Research shows that rescuers who started CPR with opening the airway took 30 critical seconds longer to begin chest compressions than rescuers who began CPR with chest compressions.
The change in the CPR sequence applies to adults, children and infants, but excludes newborns.
Other recommendations, based mainly on research published since the last AHA resuscitation guidelines in 2005:
- During CPR, rescuers should give chest compressions a little faster, at a rate of at least 100 times a minute.
- Rescuers should push deeper on the chest, compressing at least two inches in adults and children and 1.5 inches in infants.
- Between each compression, rescuers should avoid leaning on the chest to allow it to return to its starting position.
- Rescuers should avoid stopping chest compressions and avoid excessive ventilation.
- All 9-1-1 centers should assertively provide instructions over the telephone to get chest compressions started when cardiac arrest is suspected.
Since 2008, the American Heart Association has recommended that untrained bystanders use Hands-Only CPR — CPR without breaths — for an adult victim who suddenly collapses. The steps to Hands-Only CPR are simple: call 9-1-1 and push hard and fast on the center of the chest until professional help or an AED arrives.
Source: American Heart Association (AHA)