New Guidelines for Emergency Resuscitation

Based on 18 months of consultations with international resuscitation experts, the American Heart Association (AHA) has issued new guidelines for emergency cardiopulmonary resuscitation (CPR), the first changes since 1992. The changes are intended to improve the emergency care administered by both lay responders and emergency medical personnel.

The updated guidelines place major emphasis on early defibrillation for ventricular fibrillation and automatic external defibrillators (AEDs) as a tool to increase survival of victims of sudden cardiac arrest. Specifically, the guidelines recommend delivery of electric shock by a defibrillator within five minutes for an out-of-hospital sudden cardiac victim and within three minutes for an in-hospital victim.

The guidelines recognize the efficacy of new clot-busting drugs to treat heart attack and stroke, but warn they must be administered within a few hours of the onset of symptoms. Therefore, they recommend that healthcare providers use a 12-lead electrocardiogram (ECG) in a prehospital setting to determine heart damage, recognize if a heart attack or stroke victim is eligible for clot-busting therapy and notify the hospital that the patient is on the way, and transport the patient to a hospital capable of providing the most-effective treatment.

Another change is a previously announced method of giving CPR to an infant by using two-thumbs, with the fingers circling the chest, rather than the old two-finger method. The guidelines also say that laypeople should not try to take the pulse of heart attack victims, since they often do it incorrectly, which could result in not providing aid to a victim who needs it. Instead, they should check for signs of breathing, such as coughing or other movement, when deciding if CPR is needed.