Guidelines

Guideline to Great Care

The American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC), published since 1966, provides science-based recommendations for treating patients with cardiovascular emergencies, particularly adults, children, infants, and newborns with cardiac arrest. The 2015 AHA Guidelines Update for CPR and ECC is based on an international evaluation process that involved hundreds of resuscitation scientists and experts worldwide who evaluated thousands of peer-reviewed publications.

The 2015 Guidelines Update provides bystanders, dispatchers, and communities with practical guidance on how to improve the effectiveness of their teamwork, including more training to develop better systems of care. Everyone from bystanders to advanced healthcare providers should know what to do at every step of a cardiovascular emergency. The Guidelines emphasize creating a culture of action that benefits the entire community in which it operates, both inside and outside the hospital setting, and has been used to train millions in CPR, basic and advanced cardiovascular care, and first aid around the world.

Highlights of the 2015 Update

The 2015 guidelines update showed an emphasis on the use of mobile technologies by bystanders to aid in calling 911 sooner and receiving dispatch-assisted CPR instructions. Additionally, mobile technology and social media applications that notify rescuers of a nearby cardiac arrest may increase the rate of bystander-initiated CPR. Bystanders should use mobile phones to immediately call 911, placing the phones on speaker, so the dispatcher can help bystanders check for breathing, get the precise location and provide instructions for performing CPR.

Additionally, a few more highlights stood out:
  1. Dispatchers should be trained to help bystanders check for breathing and recognize cardiac arrest. Dispatchers should also be aware that brief generalized seizures may be an early sign of cardiac arrest. Mobile dispatch systems that notify potential rescuers of a nearby presumed cardiac arrest can improve the rate of bystander CPR and shorten the time to first chest compressions. Communities may want to consider this service to improve the chain of survival.
  2. Components of high-quality CPR have been updated. These include the following range for compression rate and depth:
  3. In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120/min and to a depth of at least 2 inches (5 cm) for an average adult while avoiding excessive chest compression depths (greater than 2.4 inches [6 cm]).

By developing a consensus and teaching the broadest possible audience, guidelines provide laypersons, rescuers, and professionals clarity at the moment of need on what are the immediate priorities for a critical patient.” 

-Clifton W. Calloway, MD, PhD
Associate Professor, University of Pittsburgh

Debra did ‘hands-only’ CPR while at the same time on a cell phone. What empowered Beard-Bader? She had recently seen an American Heart Association public service video about doing compression-only CPR to the beat of the “Stayin’ Alive.”

Looking to read more?

Check out these resuscitation statements for more information

  1. Bhanji, Topjian AA, Nadkarni VM, et al; and American Heart Association’s Get With The Guidelines–Resuscitation Investigators. Survival rates following pediatric in-hospital cardiac arrests during nights and weekends. JAMA Pediatr. 2017;171(1):39-45. doi: 10.1001/jamapediatrics.2016.2535.
  2. Wutzler A, von Ulmenstein S, Bannehr M, et al. Improvement of lay rescuer chest compressions with a novel audiovisual feedback device: a randomized trial [published online ahead of print April 4, 2017]. Med Klin Intensivmed Notfmed. doi: 10.1007/s00063-017-0278-9.
  3. Niles DE, Nishisaki A, Sutton RM, et al. Improved retention of chest compression psychomotor skills with brief “rolling refresher” training [published online ahead of print April 1, 2017]. Simul Healthc. doi: 10.1097/SIH.0000000000000228.

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