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Will Evans
The 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation
(CPR) and Emergency Cardiovascular Care include significant changes. The
most significant change to CPR is the ratio of chest compressions to rescue
breaths — from fifteen compressions for every two rescue breaths
in the 2000 guidelines to thirty compressions for every two breaths in
the 2005 guidelines. This thirty to two ratio for a single lay rescuer
will apply to adults, children, and infants (excluding newborns). For two-rescuer
CPR, a ratio of fifteen compressions for every two rescue breaths will
apply to children and infants (except newborns).
Another significant change is the sequence of rhythm analysis and CPR when
using an automatic external defibrillator (AED). Previously, when AED pads
were applied to the chest, the device analyzed the heart rhythm, delivered
a shock if necessary, and analyzed the heart rhythm again to determine
whether the heart had returned to a normal rhythm or needed an additional
shock. The cycle of analysis, shock, and re-analysis could be repeated
three times before CPR was recommended, resulting in delays of thirty-seven
seconds or more.
The 2005 guidelines recommend that rescuers provide two minutes of CPR
following the first shock. The AED would then re-analyze the heart rhythm
before administering another shock. Studies have shown that the first
shock from the AED stops the abnormal heart rhythm 85 percent of the
time, and that a brief period of chest compressions between shocks
can increase the oxygen delivery to the heart. The new guidelines stress
the importance of minimizing interruptions to chest compressions that
can result from rhythm checks, inserting airway devices, or administering
drugs.
The new recommendations also strongly support greater implementation
of AED programs in public locations like airports, sports facilities,
and businesses. The guidelines also reinforce the importance of planned
and practiced response to cardiac emergencies by lay rescuers.
For more details about the new guidelines, visit the American Heart
Association’s
Web site at www.americanheart.org.
Originally published in the 2006 Winter issue
of The CampLine.
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