AMERICAN HEART ASSOCIATION

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Presentation transcript:

AMERICAN HEART ASSOCIATION CHANGES IN THE 2010 GUIDELINES AFFECTING ALL RESCUERS

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Health Care Provider* “PUSH HARD AND PUSH FAST” At least 100 COMPRESSIONS / MINUTE* Allow the chest to recoil -- equal compression and relaxation times <10 seconds for pulse checks or rescue breaths Compression Depth* Adults 2” Child/Infant 1/3 depth of chest 1.5" infant 2" child Avoid excessive ventilations

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES A-B-C changed to C-A-B* Critical element is chest compressions Delay in A-B Avoidance of A & B Early defib If alone--call and retrieve AED Exception asphyxial arrest

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Cricoid pressure not recommended Advanced airway = 1 every 6-8 seconds Adult: 1 every 5-6 Peds: 1 every 3 With advanced airway- no pause

Dispatcher Identification SCA = seizure & agonal gasps Trained to ID – ask if breathing is normal Only gasping??? Provide CPR instructions

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES AHA ECC Adult Chain of Survival - New

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Lay Rescuer – Hands-only CPR (untrained vs trained) Easier Guided by dispatchers SR are same

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Simplified Universal BLS algorithm

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Electrical Therapies Shock first vs CPR first No precordial thump CPR devices – no data for AED in hospital (goal to shock =< 3 mins) Use in infants (with or without attenuator)

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES ACLS Simplified algorithm Optimized CPR quality with monitoring Waveform capnography (>12 mmHg) Atropine deleted (PEA/Asystole) Chronotropic drugs for brady, then pacing Adenosine safe for monomorphic wide tachs Post-cardiac arrest

AMERICAN HEART ASSOCIATION CAPNOGRAPHY

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Post-Cardiac Arrest – ROSC Therapeutic Hypothermia Remain comatose 32-34 degree C (all ages) (89.6-93.2 F) 12-24 hours PCI O2 sat ≥94% & PETCO 35-40

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Special Resuscitation Situations Asthma Anaphylaxis Pregnancy Morbid obesity PE Electrolyte imbalance Toxins Hypothermia Avalanche Drowning Electric shock/lightening PCI Cardiac tamponade Cardiac surgery

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Acute Coronary Syndromes Out of hospital 12-lead Triage to PCI Oxygen – > 94 % is the goal (capno) Morphine – use with caution in UA/non-STEMI

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Stroke Stroke-prepared hospitals Triage to stroke centers TPA up to 4.5 hours

AMERICAN HEART ASSOCIATION: 2010 GUIDELINES Learning to Mastery New CPR Prompts devices Online training: http://www.onlineaha.org/ Instructor network http://ahainstructornetwork.americanheart.org/AHAECC/ecc.jsp?pid=ahaecc.signin&_requestid=133687