Heart group simplifies guidelines for CPR

In this story: New guidelines easier to follow More defibrillators recommended RELATED STORIES, SITES

WASHINGTON (CNN) -- Used effectively, cardiopulmonary resuscitation can save lives. Every year, some 5 percent of people who go into sudden cardiac arrest outside a hospital owe their survival to the technique.

Now the American Heart Association is streamlining the process to make it even easier for people who have no medical training.

In the United States, "225,000 people a year die because of an out-of-hospital arrest," American Heart Association President Dr. Rose Marie Robertson said Tuesday. "If we could increase that (survival rate) by 20 percent, 50,000 more people could be saved."

RESOURCES To find a CPR class near you, visit the American Heart Association's Emergency Cardiovascular Care Program site or call 1-877-AHA-4-CPR    Background: The most common warning signals of a heart attack, according to the American Heart Association: Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes Pain spreading to the shoulders, neck or arms Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath Less common warning signs of heart attack include: Atypical chest pain, stomach or abdominal pain Nausea or dizziness Shortness of breath and difficulty breathing Unexplained anxiety, weakness or fatigue Palpitations, cold sweat or paleness Source: American Heart Association

Simplifying CPR instructions to incorporate the latest available research is a sensible way to begin, said Robertson, who is a cardiologist, professor and vice chairman of the Department of Medicine at Vanderbilt University Medical Center in Nashville, Tennessee.

"We always want our programs to be based on the most up-to-date science," she continued. "In addition, there is a desire to have the international community come together so it could be taught the same around the world."

Changes in CPR guidelines mean that people who have been trained to use the technique need to be recertified. Retraining is usually necessary every year in any case. New educational materials are now being distributed across the country, Robertson said, adding that all should be in place by the middle of next year.

Current guidelines, adopted in 1992, call for rescuers to follow the "ABCs" of CPR by checking the victim's airway, breathing and circulation. If the airway is unblocked and the person still isn't breathing, CPR instruction then directs rescuers to check for a pulse. However, surveys have found that "35 percent of the time, they are wrong," said Robertson.

New guidelines released Tuesday eliminate the pulse check and urge people to look for alternative signs that someone's heart is beating, such as normal breathing, coughing and movement.

If no such signs are present, the guidelines instruct people to proceed to using chest compressions and rescue breathing in a ratio of 15 compressions to two breaths. This should be repeated in succession at a rate of 100 compressions a minute, a change from the former rules, which called for a range of 80 to 100 compressions a minute.

"If you give people too many things to remember, it's tough to remember them," said Robertson said of the process.

"By using the technology that we have, we've been able to simplify CPR techniques for the lay public down to these very few interventions that really make a difference," said emergency cardiovascular care physician Vinay Nadkarni.

Also changed are instructions on treating an unconscious choking victim. Instead of sweeping the mouth or using the Heimlich maneuver to dislodge a blockage, use only chest compressions, the association recommended. This lessens the chance that any blockage will be depressed further into the airway.

It is important to note, however, that the first step remains to call a local emergency medical service or 911.

But knowing what to do until medical personnel arrive is critical to a victim's prospects for survival.

Also critical, said Robertson, is the availability of an automated external defibrillator, or AED. Such devices cost about $3,000 each, and are already in use on some airlines and in some other public places.

There should be many more available, as well as people trained in their use, Robertson added, saying AEDs should be handy in sports stadiums and other public venues where people concentrate and an emergency is likely.

"If you think about a sports stadium, and the number of arrests every year, adding a defibrillator would only add pennies to the cost of a sports event," said Robertson.

With every minute we lose (in delaying defibrillation), we lose 7 to 10 percent of people we could save," she continued. "So you can see that if we delay 10 minutes, the chances of saving somebody really drops off."

CNN Medical Correspondent Rhonda Rowland contributed to this report.

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American Heart Association
  • Emergency Cardiovascular Care Programs
  • CPR and Emergency Care
National Registry of Cardiopulmonary Resuscitation

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