As the results of ongoing scientific research continue to emerge, knowledge of health and medicine rapidly expands.  For the American Heart Association, this means constant revision of recommendations for appropriate treatment of cardiac arrest, otherwise known as cardiopulmonary resuscitation, or CPR.  Research done throughout the past decade has led to a number of significant changes over the last few years in the AHA’s guidelines for CPR and have been adapted in the CPR Classes in Marin.  An awareness and understanding of these changes is critical for those who participate in emergency medical care, as well as for those who facilitate the education of caregivers.

Perhaps the most notable of the AHA’s altered recommendations switching from use of the acronym ABC, for Airway first, Breathing second, and Chest Compressions third, to CAB, or Chest Compressions first, Airway second, and Breathing third.  This change is based on research that has determined chest compressions to be the most critical aspect of initial basic life support, or BLS.  While maintaining an open, clear airway and assessing a patient’s respiratory status remain vital steps in resuscitative efforts, it is now believed that the inevitable delay in providing chest compressions brought about by adhering to the ABC format may result in a lower survival rate for victims of cardiac arrest.
Another reason behind prioritizing chest compressions is that researchers believe this approach will encourage more bystanders to attempt CPR.  Laypersons are often hesitant to engage in resuscitation efforts because they feel unprepared to offer adequate rescue breathing, which, in the ABC directive, comes before compressions.  When the heart fails, there is usually enough oxygen in the bloodstream to support the brain for several minutes, as long the blood is circulating.  This underlies the second major change in the AHA’s CPR guidelines dating from 2010, which emphasizes that untrained rescuers engage in Hands-Only CPR, which is taught in CPR Renewal Classes at STS of Marin.  In addition to being equally effective in terms of survival rates, Hands-Only CPR (which consists solely of chest compressions) has been shown to be more easily guided by emergency dispatchers via telephone.
Other significant changes deal with the rate and depth of chest compressions.  Prior to the revised guidelines first published in 2010, a rate of about 100 compressions per minute was recommended, in contrast to the current recommendation of at least 100 per minute.  Similarly, the previous recommended depth of compressions was one and a half to two inches, whereas current guidelines advise a depth of at least two inches.   Respectively, these changes have been made for the purposes of providing a higher number of compressions, which is associated with higher survival rates, and for minimizing the possibility of confusion, which may occur when a range of depth is recommended.
Although the 2010 revised AHA guidelines contain additional changes, the ones covered in this article are the most relevant to educators, emergency medical providers, and laypersons alike.  By understanding and adhering to these alterations and taking a CPR Class at STS in Novato, CA, both trained and untrained rescuers will enhance their ability to provide effective emergency care in the case of cardiac arrest, whether to patients within treatment facilities, family members within the home, or strangers in public.

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