1. Pfeifer, Gail M. MA, RN

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This past November, the American Heart Association (AHA) released new guidelines on cardiopulmonary resuscitation (CPR) and emergency cardiovascular care, after experts performed a review of the existing evidence on survival and techniques for treating sudden cardiac arrest. The new instructions are simpler, primarily as a benefit to lay rescuers; this was done to minimize the differences in the techniques used to treat infants, children, and adults. One goal of simplifying the guidelines is to attract more people to CPR training, thereby increasing the number of bystanders at a cardiac emergency who have the skills and are willing to respond; it's hoped that this will reduce the number of deaths from sudden arrest in out-of-hospital settings. And although the focus of the guidelines is on better-quality basic life support, particularly for lay rescuers, they include important changes in adult and pediatric advanced cardiac life support technique by providers.


"Push hard and push fast" is the new mantra.

The universal rate of compression should be 100 per minute, except in newborns; full recoil of the chest after every compression should be noted. Those performing CPR by themselves should employ a compression-to-ventilation ratio of 30:2, which is a change from the 2000 recommendation of 15:2. According to Mary Fran Hazinski, MSN, RN, FAAN, senior science editor for the AHA's Emergency Cardiovascular Care programs, nurses should mark two-minute intervals for rhythm checks while performing CPR and prepare the next likely drug to be delivered, to minimize interruptions to chest compression.


The complete guidelines are available at A companion site also has links to Web casts for hospital practitioners and instructors, emergency medical service rescuers, and corporate and community instructors ( The AHA has released a DVD for instructors to help them integrate the new changes, but the organization says that, until providers receive training in the new techniques, the use of the current technique is safe and effective.

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