Oct 21, 2015
All the details behind the 2015 AHA Guidelines Update For CPR and ECC
As we briefly touched on with our last post, the American Heart Association (AHA) recently released their 2015 Guidelines Update for CPR and ECC. The latest recommendations are a result of the AHA’s effort to update the guidelines every 5 years in order to refine and improve them. The AHA routinely updates their guidelines and recommendations on a 5-year cycle based on new findings and ongoing research in resuscitation science.
While the 2010 updates led to a significant shift in the manner of which resuscitation is delivered, the 2015 updates don’t appear to be as radical. The fact is that there simply was no need to completely overhaul the resuscitation science that has been saving lives for years. Thus, the ECC Committee determined that this 2015 version would only be a minor update, and would address only the topics mentioned by the 2015 ILCOR evidence review. To learn more about the ILCOR Scientific Evidence Evaluation and Review System (SEERS) that was behind the update, see here. So while many of the foundations remained intact, there are plenty of refinements and additions that have been implemented in order to adapt to the ever-changing nature of healthcare.
The new updates highlight the importance of quick action, teamwork, and proper training, as well as the ever-increasing importance of using mobile technology to improve the chances of survival.
This is the first time we have seen the guidelines really encourage the use of mobile phones and apps, a testament to the digital world we live in today. While some are hesitant to adapt technology into their lives, there’s no denying how crucial it can be in emergency situations. Cardiac arrest is one of the leading causes of death we face today, with roughly 360,000 out-of-hospital cases in the United States each year. When it strikes, the single most important factor in saving a life is quick action, something that has been aided by increased technology in all areas of life. Encouraging the use of social media and other mobile devices was inevitable, and for good reason.
Another area that was stressed in the guideline update is the importance of coordinated efforts when performing CPR. The largest change within the guidelines pertains to the Chain of Survival, which has now been split into two for In-Hospital Cardiac Arrest (OHCA).
Here are several key points taken directly from the 2015 AHA Guidelines Update in regards to the OCHA Chain of Survival – from bystanders to dispatchers – and the importance of teamwork in such situations.
- Untrained bystanders should still call 911 and provide Hands-Only CPR, or CPR without breaths, pushing hard and fast in the center of the chest to the rate of 100-120* compressions per minute. However, if the bystander is trained in CPR and can perform breaths, he or she should add breaths in a 30:2 compressions-to-breaths ratio.
- Bystanders should use mobile phones to immediately call 911, placing the phones on speaker, so the dispatcher can help bystanders check for breathing, get the precise location and provide instructions for performing CPR.
- Dispatchers should be trained to help bystanders check for breathing and recognize cardiac arrest. Dispatchers should also be aware that brief generalized seizures may be an early sign of cardiac arrest.
- Mobile dispatch systems that notify potential rescuers of a nearby presumed cardiac arrest can improve the rate of bystander CPR and shorten the time to first chest compressions. Communities may want to consider this service to improve the Chain of Survival.
While most of what we have covered so far has dealt with out-of-hospital cardiac arrest scenarios, the 2015 AHA Guidelines Update also addressed changes that needed to be made for cases occurring within hospital doors. Much like the overall theme for the entire update, these changes are by no means extreme, and deal mostly with the general improvements to the System of Care. More so, the update tries to create a more integrated, common resuscitation framework to be used in settings both inside and outside of hospitals. For example, further emphasis has been placed on the performance of chest compressions during CPR, adding an upper limit to how deep and how quickly compressions should take place.
Every 5 years the AHA updates their guidelines, and some of the updates are more radical than others. This update just so happens to be a relatively subtle one – by design. When to release more extensive updates and when to merely refine is not done by a predetermined schedule, but rather through an extensive process involving thousands of people. Meaning, the AHA does not plan on making big changes during 2020 update only because the 2015 update didn’t involve as much. Instead, as they did with this update and every previous update before, they will hold an extensive evaluation process will all types of contributing knowledge, ranging from resuscitation experts to medical publications, to make the most educated decisions possible.
For more information on the 2015 AHA Guidelines for CPR and ECC, see here.