New CPR Guidelines Emphasize Chest Compression First

AHA guideline change intended to get heart beating first, then breathing restarted
By Jeff Muise
HealthDay Reporter

TUESDAY, Oct. 19 (HealthDay News) -- Lay and professional rescuers using cardiopulmonary resuscitation (CPR) to revive someone stricken by cardiac arrest should begin chest compressions first to quickly restore blood circulation, rather than risk the delay to clear the patient's airway and restart breathing, according to the "2010 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care," published online Oct. 18 in Circulation.

John M. Field, M.D., of Penn State University in Hershey, and more than 30 colleagues in the AHA's writing group conducted a comprehensive review of the medical literature and sought input from 356 resuscitation experts from 29 countries before drafting the new guidelines. In addition to the change in the CPR sequence, the guidelines contain several new recommendations based mainly on research published since the last AHA guidelines in 2005.

Among the recommendations for lay persons: give chest compressions at a rate of at least 100 times a minute; push deeper on the chest, compressing at least 2 inches in adults and children and 1.5 inches in infants; avoid any lapses in chest compressions; and avoid excessive ventilation. Emergency centers (911) should clearly provide instructions over the telephone to get chest compressions started first. The AHA guidelines recommend health care professionals practice resuscitation teamwork techniques, and drop a recommendation for atropine to treat pulseless electrical activity and asystole.

"Despite our success, the research behind the guidelines is telling us that more people need to do CPR to treat victims of sudden cardiac arrest, and that the quality of CPR matters, whether it's given by a professional or non-professional rescuer," AHA president, Ralph Sacco, M.D., said in a statement.

Numerous members of the writing team disclosed receiving research grants/support/honoraria from, serving as an advisor or consultant for, or holding stock in pharmaceutical companies.

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