1. AMERICAN HEART ASSOCIATION
CHANGES IN THE 2010 GUIDELINES AFFECTING ALL RESCUERS

2. 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 " infant " child
Avoid excessive ventilations

3. 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

4. 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

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

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

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

8. AMERICAN HEART ASSOCIATION: 2010 GUIDELINES
Simplified Universal
BLS algorithm

9. 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)

10. 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

11. AMERICAN HEART ASSOCIATION
CAPNOGRAPHY

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

13. 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

14. 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

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

16. AMERICAN HEART ASSOCIATION: 2010 GUIDELINES
Learning to Mastery
New CPR Prompts devices
Online training:
Instructor network