Paramedico

H i g h l i g h t s o f t h e 2010
American Heart Association

Guidelines for CPR and ECC
Contents
Major Issues Affecting All Rescuers Lay Rescuer Adult CPR Healthcare Provider BLS Electrical Therapies CPR Techniques and Devices Advanced Cardiovascular Life Support Acute Coronary Syndromes Stroke Pediatric Basic Life Support Pediatric Advanced Life Support Neonatal Resuscitation EthicalIssues Education, Implementation, and Teams First Aid Summary 25 26 28 20 22 24 13 17 18 18 1 3 5 9 12

Editor
Mary Fran Hazinski, RN, MSN

Associate Editors
Leon Chameides, MD Robin Hemphill, MD, MPH Ricardo A. Samson, MD Stephen M. Schexnayder, MD Elizabeth Sinz, MD

Contributor
Brenda Schoolfield

Guidelines Writing Group Chairs and Cochairs
Michael R. Sayre, MD Marc D. Berg, MD RobertA. Berg, MD Farhan Bhanji, MD John E. Billi, MD Clifton W. Callaway, MD, PhD Diana M. Cave, RN, MSN, CEN Brett Cucchiara, MD Jeffrey D. Ferguson, MD, NREMT-P Robert W. Hickey, MD Edward C. Jauch, MD, MS John Kattwinkel, MD Monica E. Kleinman, MD Peter J. Kudenchuk, MD Mark S. Link, MD Laurie J. Morrison, MD, MSc Robert W. Neumar, MD, PhD Robert E. O’Connor, MD, MPH Mary Ann Peberdy, MD Jeffrey M.Perlman, MB, ChB Thomas D. Rea, MD, MPH Michael Shuster, MD Andrew H. Travers, MD, MSc Terry L. Vanden Hoek, MD

© 2010 American Heart Association

MAJOR i major Issues
his “Guidelines Highlights” publication summarizes the key issues and changes in the 2010 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). It hasbeen developed for resuscitation providers and for AHA instructors to focus on resuscitation science and guidelines recommendations that are most important or controversial or will result in changes in resuscitation practice or resuscitation training. In addition, it provides the rationale for the recommendations. Because this publication is designed as a summary, it does not reference thesupporting published studies and does not list Classes of Recommendations or Levels of Evidence. For more detailed information and references, the reader is encouraged to read the 2010 AHA Guidelines for CPR and ECC, including the Executive Summary,1 published online in Circulation in October 2010 and to consult the detailed summary of resuscitation science in the 2010 International Consensus on CPR andECC Science With Treatment Recommendations, published simultaneously in Circulation2 and Resuscitation.3 This year marks the 50th anniversary of the first peer-reviewed medical publication documenting survival after closed chest compression for cardiac arrest,4 and resuscitation experts and providers remain dedicated to reducing death and disability from cardiovascular diseases and stroke.Bystanders, first responders, and healthcare providers all play key roles in providing CPR for victims of cardiac arrest. In addition, advanced providers can provide excellent periarrest and postarrest care. The 2010 AHA Guidelines for CPR and ECC are based on an international evidence evaluation process that involved hundreds of international resuscitation scientists and experts who evaluated, discussed,and debated thousands of peerreviewed publications. Information about the 2010 evidence evaluation process is contained in Box 1.

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MAJOR ISSUES AFFECTING ALL RESCUERS
This section summarizes major issues in the 2010 AHA Guidelines for CPR and ECC, primarily those in basic life support (BLS) that affect all rescuers, whether healthcare providers or lay rescuers. The 2005 AHA Guidelines forCPR and ECC emphasized the importance of high-quality chest compressions (compressing at an adequate rate and depth, allowing complete chest recoil after each compression, and minimizing interruptions in chest compressions). Studies published before and since 2005 have demonstrated that (1) the quality of chest compressions continues to require improvement, although implementation of the 2005...