A new order for CPR, spelled C-A-B
Please find an electronic press kit that includes a stats/fact sheet, chart of key changes, steps of CPR, CPR graphic and survivor stories at this link: http://www.pimsmultimedia.com/AHA_CPR/.
- The 2010 AHA Guidelines for CPR and ECC update the 2005 guidelines.
- When administering CPR, immediate chest compressions should be done first.
- Untrained lay people are urged to administer Hands-Only CPR (chest compressions only).
DALLAS, Oct. 18, 2010 — The American Heart Association is re-arranging the ABCs of cardiopulmonary resuscitation (CPR) in its 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, published in Circulation: Journal of the American Heart Association.
Recommending that chest compressions be the first step for lay and professional rescuers to revive victims of sudden cardiac arrest, the association said the A-B-Cs (Airway-Breathing-Compressions) of CPR should now be changed to C-A-B (Compressions-Airway-Breathing).
“For more than 40 years, CPR training has emphasized the ABCs of CPR, which instructed people to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth, and only then giving chest compressions,” said Michael Sayre, M.D., co-author of the guidelines and chairman of the American Heart Association’s Emergency Cardiovascular Care (ECC) Committee. “This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compressions right away.”
In previous guidelines, the association recommended looking, listening and feeling for normal breathing before starting CPR. Now, compressions should be started immediately on anyone who is unresponsive and not breathing normally.
All victims in cardiac arrest need chest compressions. In the first few minutes of a cardiac arrest, victims will have oxygen remaining in their lungs and bloodstream, so starting CPR with chest compressions can pump that blood to the victim’s brain and heart sooner. Research shows that rescuers who started CPR with opening the airway took 30 critical seconds longer to begin chest compressions than rescuers who began CPR with chest compressions.
The change in the CPR sequence applies to adults, children and infants, but excludes newborns.
Other recommendations, based mainly on research published since the last AHA resuscitation guidelines in 2005:
- During CPR, rescuers should give chest compressions a little faster, at a rate of at least 100 times a minute.
- Rescuers should push deeper on the chest, compressing at least two inches in adults and children and 1.5 inches in infants.
- Between each compression, rescuers should avoid leaning on the chest to allow it to return to its starting position.
- Rescuers should avoid stopping chest compressions and avoid excessive ventilation.
- All 9-1-1 centers should assertively provide instructions over the telephone to get chest compressions started when cardiac arrest is suspected.
“Sudden cardiac arrest claims hundreds of thousands of lives every year in the United States, and the American Heart Association’s guidelines have been used to train millions of people in lifesaving techniques,” said Ralph Sacco, M.D., president of the American Heart Association. “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.”
Since 2008, the American Heart Association has recommended that untrained bystanders use Hands-Only CPR — CPR without breaths — for an adult victim who suddenly collapses. The steps to Hands-Only CPR are simple: call 9-1-1 and push hard and fast on the center of the chest until professional help or an AED arrives.
Key guidelines recommendations for healthcare professionals:
- Effective teamwork techniques should be learned and practiced regularly.
- Professional rescuers should use quantitative waveform capnography — the monitoring and measuring of carbon dioxide output — to confirm intubation and monitor CPR quality.
- Therapeutic hypothermia, or cooling, should be part of an overall interdisciplinary system of care after resuscitation from cardiac arrest.
- Atropine is no longer recommended for routine use in managing and treating pulseless electrical activity (PEA) or asystole.
Pediatric advanced life support (PALS) guidelines provide new information about resuscitating infants and children with certain congenital heart diseases and pulmonary hypertension, and emphasize organizing care around two-minute periods of uninterrupted CPR.
The CPR and ECC guidelines are science-based recommendations for treating cardiovascular emergencies — particularly sudden cardiac arrest in adults, children, infants and newborns. The American Heart Association established the first resuscitation guidelines in 1966.
The year 2010 marks the 50th anniversary of Kouwenhoven, Jude, and Knickerbocker’s landmark study documenting cardiac arrest survival after chest compressions.
A complete list of authors is on the manuscript.Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy most manufacturers and other companies) also make donations and fund specific association programs and events.
Heat Fatalities [Map]
This map shows locations of outdoor worker, heat-related fatalities between 2008 and 2013. It is not an exhaustive list of all worker fatalities from heat exposure during this time period. It includes only those fatalities that involve workers who are covered by either the Federal Occupational Safety and Health Administration (Federal OSHA) or a State OSHA plan. Some fatalities reported to the Bureau of Labor Statistics (BLS) are outside Federal and State plan OSHA jurisdiction and are not included. In addition, reporting and update timeframes for the Federal OSHA information systems used to generate this map vary from BLS and are based on the circumstances of the case, which may result in inconsistencies.
The map provides a geographic reminder that Water.Rest.Shade are vital to providing a safe and healthful environment when working outdoors in the heat. For each fatality, basic information about the type of workplace, work task, and work conditions is provided if available. This information was drawn from both preliminary and final investigation reports. Links to available inspection data are provided for incidents recorded on OSHA's Statistics & Data webpage. Once an OSHA investigation is complete, any preliminary data will be updated. Additional incidents will be added as information becomes available.
Select a location and click on the pin to view the incident information box. You can also close the box by clicking on the pin. To move the information box, click and drag the box to the desired position. A text version of the information presented on this map is also available.
Why should employers make Automated External Defibrillators available to employees?
Automated External. Defibrillators Can Save Lives
During Cardiac Emergencies Automated External Defibrillators (AEDs)
improve survival after an out-of-hospital cardiac arrest. Their presence reduces the critical time for treatment. Less time to defibrillation improves victims’ chances of survival. Having the devices appropriately located in a business or workplace improves the survivability of people experiencing a cardiac crisis.
Why should employers make Automated
External Defibrillators available to
■ There are 300,000-400,000 deaths per year
in the United States from cardiac arrest.
■ Most cardiac arrest deaths occur outside the
hospital. Current out-of-hospital survival rates
are 1 to 5 percent.
■ In 1999 and 2000, 815 of 6,339 workplace
fatalities reported to OSHA were caused by
■ Jobs with shift work, high stress, and exposure
to certain chemicals and electrical hazards
increase the risks of heart disease and cardiac
What causes cardiac arrest, and how does an AED improve survivability?
■ Abnormal heart rhythms, with ventricular
fibrillation (VF) being the most common,
cause cardiac arrest.U.S. Department of Labor
Occupational Safety and Health Administration
OSHA 3174 (2001)
■ Treatment of VF with immediate electronic
defibrillation can increase survival to more
than 90 percent.
■ With each minute of delay in defibrillation,
10 percent fewer victims survive.
Is AED equipment expensive?
■ The average initial cost for an AED ranges
from $1,000 to $4,500.
Are AEDs difficult to use?
■ AEDs are easy to use. In mock cardiac arrest,
untrained sixth-grade children were able to
use AEDs without difficulty.
■ Automated external defribrillators are effective,
easy to use, and relatively inexpensive. As a
matter of policy, OSHA does not endorse or
approve specific products or product
For more information:
See OSHA’s website at www.osha.gov or visit the
American Heart Association website at www.cpr-ecc.org.