AMERICAN HEART ASSOCIATION

CHANGES IN THE 2010 GUIDELINES AFFECTING ALL RESCUERS

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Health Care Provider*
PUSH HARD AND PUSH FAST At least 100 COMPRESSIONS / MINUTE* Allow the chest to recoil -- equal compression and relaxation times <10 seconds for pulse checks or rescue breaths Compression Depth*
Adults 2 Child/Infant 1/3 depth of chest 1.5" infant 2" child

Avoid excessive ventilations

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
A-B-C changed to C-A-B*
Critical element is chest compressions
Delay in A-B Avoidance of A & B

Early defib If alone--call and retrieve AED

Exception asphyxial arrest

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES

Cricoid pressure not recommended
Advanced airway = 1 every 6-8 seconds
Adult: 1 every 5-6 Peds: 1 every 3

With advanced airway- no pause

Dispatcher Identification
SCA = seizure & agonal gasps Trained to ID ask if breathing is normal Only gasping??? Provide CPR instructions

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
AHA ECC Adult Chain of Survival - New

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Lay Rescuer Hands-only CPR (untrained vs trained)
Easier Guided by dispatchers SR are same

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Simplified Universal BLS algorithm

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Electrical Therapies Shock first vs CPR first No precordial thump CPR devices no data for AED in hospital (goal to shock =< 3 mins) Use in infants (with or without attenuator)

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
ACLS
Simplified algorithm Optimized CPR quality with monitoring Waveform capnography (>12 mmHg) Atropine deleted (PEA/Asystole) Chronotropic drugs for brady, then pacing Adenosine safe for monomorphic wide tachs Post-cardiac arrest

AMERICAN HEART ASSOCIATION

CAPNOGRAPHY

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Post-Cardiac Arrest ROSC
Therapeutic Hypothermia
Remain comatose 32-34 degree C (all ages) (89.6-93.2 F) 12-24 hours

PCI
O2 sat 94% & PETCO 35-40

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Special Resuscitation Situations
Asthma Anaphylaxis

Hypothermia
Avalanche Drowning Electric shock/lightening PCI Cardiac tamponade Cardiac surgery

Pregnancy
Morbid obesity PE Electrolyte imbalance Toxins

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Acute Coronary Syndromes Out of hospital 12-lead Triage to PCI Oxygen > 94 % is the goal (capno) Morphine use with caution in UA/non-STEMI

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Stroke
Stroke-prepared hospitals

Triage to stroke centers

TPA up to 4.5 hours

AMERICAN HEART ASSOCIATION:

2010 GUIDELINES
Learning to Mastery
New CPR Prompts devices Online training: http://www.onlineaha.org/ Instructor network
http://ahainstructornetwork.americanheart.org/AHAECC/ecc.jsp?pid=ahaecc.signin&_requestid=133687