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New CPR Guidelines Emphasize Chest Compressions

October 18, 2010

The American Heart Association released new cardiopulmonary resuscitation (CPR) guidelines on Monday, placing a greater emphasis on the use of chest compressions and advising would-be rescuers to not stop and listen for breathing before beginning the procedure.

The new guidelines, which have been published in Circulation: Journal of the American Heart Association, move away from the organization’s long-utilized “ABCs of CPR” method. The “ABC” method, which stood for Airway-Breathing-Compressions, should now be replaced with the CAD method, which places compressions before pulmonary treatment.

“For more than 40 years, CPR training has emphasized the ABCs of CPR, which instructed people to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth, and only then giving chest compressions,” Michael Sayre, co-author of the guidelines and the chairman of the American Heart Association’s Emergency Cardiovascular Care (ECC) Committee, said in a statement on Monday.

“This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compressions right away,” Sayre added.

Furthermore, the new CPR guidelines suggest that lay or professional rescuers should begin compressions immediately on anyone–except newborns–if they are not responsive and/or not breathing normally. They also recommend that the rate of chest compressions be increased to 100 times per minute and should be deeper on the chest, with a compression rate of 1.5 inches on infants and at least two inches on children and adults. They also advise rescuers to avoid leaning on the chest in between compressions, in order to allow the chest to return to its normal position.

“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,” the American Heart Association said in the October 18 press release. “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.”

Earlier this month, a University of Arizona study found that hands-only CPR could be more effective than mouth-to-mouth resuscitation. The researchers looked at more than 4,400 instances of adult cardiac arrest that occurred in non-hospital settings between 2005 and 2009, and discovered that 13% of those who received hands-only resuscitation survived, compared to 8% who were given conventional CPR. The Arizona study was published in Journal of the American Medical Association (JAMA).

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