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.