AHA New Guidelines 2010
for CPR
C.P.R.
• CARDIO
= Heart
• PULMONARY
= Lung
• RESUSCITATION
= Revival
sudden cardiac
arrest
• EMS treats nearly 300,000 out of hospital cardiac
arrest each year in the U.S.
• Less than 8 percent of people who suffer cardiac
arrest outside of the hospital survive to make it
home from the hospital.
• Nationally, only 20 % get bystander help
• Locally, 50 % receive help
CPR facts
• 500,000 deaths a year due to cardiac arrest
• 250,000 will die before they reach the hospital
• 50% show up by private car to the hospital
• Avg. person waits 2 hours before seeking help – are more
likely to go into cardiac arrest within the 1st hour
• Effective bystander CPR provided immediately after sudden
cardiac arrest, can double or triple a victim’s chance of
survival.
• 13 million people worldwide are trained in CPR.
CPR Facts
• Best place to have a heart attack?
• Las Vegas
• Worst Place?
*Detroit Michigan – 0%
*Washington DC – 5%
Seattle/King Co. – 50%
Are over 250 AED’s at SeaTac Airport
Most Common TIMES
CPR is Needed
Heart Attack
Drug Overdose
Drowning
Smoke Inhalation
Electrical Shock
Choking
AHA Adult chain of
survival
• 1. Immediate recognition of cardiac arrest and
activation of the emergency response.
• 2. Early CPR with emphasis on chest compressions.
• 3. Rapid defibrillation
• 4. Effective advanced life support
• 5. Integrated post-cardiac arrest care.
HEART ATTACK
• “Death of part of the heart muscle due to
inadequate supply of blood and oxygen.”
• Signs of a heart attack:
• Severe chest pain or pressure
• Sweating, nausea, shortness of breath,
weakness, fainting, heartburn, back pain
*Signs may last for several minutes
Sudden Cardiac
Arrest
• Cardiac arrest is present when the heart stops
pumping.
• The most common cause of cardiac arrest in
adults is an abnormal heart rhythm called
ventricular fibrillation (VF)
• In VF the heart quivers uselessly and does not
pump blood.
• VF requires an immediate electric shock –
defibrillation – to the heart to allow the normal
heart rhythm to resume
Sudden Cardiac Arrest
• The best chance for survival depends on early
CPR and early defibrillation
• For every minute that passes without
defibrillation, the victim’s chances of survival
falls by 7 – 10 % (unless CPR is provided)
• 4 minutes: Brain damage begins
• 10-12 minutes: Chance of survival is small
unless CPR is provided
Time is Crucial
Once breathing has stopped, brain cells begin to die.
CPR Started in
Chance of Recovery
1 minute
90%
4 – 6 minutes
50%
7+ minutes
10%
New Steps to CPR
Aed AND PERSONNEL
• One Rescuer
• Unresponsiveness – Call 911 and get the AED
• BEGIN COMPRESSIONS AND BREATHING
• Attach AED
• Two Rescuer
• #1 – Call 911/Perform CPR
• #2 – Attach AED
*If an AED is on site – don’t start CPR
*If no AED on site – start CPR and continue until
an AED arrives
Tap and shout
• Tap and Shout to check for
unresponsiveness.
• 10% of victims have seizures while in cardiac
arrest. Are often found laying down so often
people “leave them alone.” Have to roll them
over to check.
Yell for help. Send someone
to phone 911 an get an aed
• When calling 9-1-1…
• Give the specific location
• Phone # of where they can reach you
• Nature/Extent of the emergency
• Advise that AED is on the scene or NOT
• Don’t hang up until the dispatcher advises
Infant, child, adult
CPR
Infant
Child
Adult
30:2
30:2
30:2
2 fingers
1 Hand
2 Hands
About 1 ½ inches At least 2 inches
At least 2 inches
100 X a min.
100 X a min.
100 X a min.
1 yr. or younger
Age 1 - 8
8 and older
Guideline for Chest
Compressions
• Position victim on a hard surface on their back
• Remove clothing from chest
• Locate correct hand position on the center of the chest and on the
lower half of the breastbone, right between the nipples.
• Place the heel of one hand on the sternum and place the other
hand on top.
• Depress sternum 2 inches
• Provided 30 chest compressions at a rate of at least100 x per
minute. Make sure to have complete chest recoil!
• Give 30 compressions, (if trained and proficient give 2 breaths
lasting one second each)
• Count out loud…”One and two…” to the beat of “Staying Alive”
“Open AIRWAY”
• Airway can be blocked by the tongue
• Position victim
• Open the airway
• Head tilt-chin lift (or jaw thrust)
Suspected Neck Injury
• If a neck (spinal) injury is
suspected, use the jaw thrust.
Position yourself at the victim's
side and without tilting the head,
lift the jaw.
BREATHING
• While holding the airway open, pinch the
nose closed.
• Take a breath. Cover the person’s mouth
with your mouth.
• Give 2 full breaths (1 second each) Watch for
the chest to begin to rise as you give each
breath.
AGoNOL BREATHING
• Sometimes the victim will sound like they are
snoring. This is not an indication of true
breathing. Agonal breathing is an indication
that CPR needs to be started.
Special
considerations
• Is victim lying in water?
• Is victim less than 8 years old?
• Is victim wearing a transdermal
medication patch on his/her chest?
• Does the victim have a pacemaker or
implanted defibrillator?
Effectiveness of pads
aed
defibrillation
• Right Electrode Pad
• To the right of the breastbone
• Below the collarbone above the nipple
• Left Electrode Pad
• Outside the left nipple, upper edge of
the pad several inches below the armpit
choking
• The choking sign is holding the
neck with one or both hands.
• “There are more than 3000
deaths per year in the US due to
choking.”
Signs of choking
• Mild signs include: Can make sounds or can cough
loudly. You should: Stand by and let him/her
cough.
• Severe signs may include: Cannot breathe or has a
cough that has no sound or cannot talk or make a
sound or makes the choking sign. You should: Act
quickly and follow the steps to help a choking adult.
Action to help a
choking conscious
adult
• If you think someone is choking, ask, “Are you choking?” If
victim nods yes, tell them you are going to help.
• Get behind him/her. Wrap your arms around him/her so that your
hands are in front.
• Make a fist with 1 hand.
• Put the thumb side of your fist slightly above the belly button and
well below the breastbone.
• Grasp the fist with your other hand and give quick upward thrusts
into abdomen.
• Give thrusts until the object is forced out and the victim can
breather, cough, or talk, or until victim stops responding.
Special circumstances
• If someone is choking and is in the late stages of
pregnancy or is a very large person, give thrusts on
the chest instead of thrusts on the abdomen.
• Put your arms under the armpits and your hands on
the lower half of the breastbone. Pull straight back
to give the chest thrusts.
How to help a
choking child
• If you think the child is choking, ask “Are you choking?” If victim
nods yes, tell him you are going to help.
• Get behind the victim. Wrap your arms around him/her so that
your hands are in front.
• Make a fist with 1 hand.
• Put the thumb side of your fist slightly above the belly button and
well below the breastbone.
• Grasp the fist with your other hand and give quick upward thrusts
into the abdomen.
• Give thrusts until the object is forced out and he can breathe,
cough, or talk, or until victim stops responding.
How to help a
choking infant
• Hold the infant facedown on your forearm. Support
he infant’s head and jaw with your hand.
• Give up to 5 back slaps with the heel of your other
hand between the infant’s shoulder blades.
• Give up to 5 chest thrusts using 2 fingers of your
other hand to push on the chest in the same place you
push for CPR.
• Repeat giving 5 back slaps and 5 chest thrusts until
the infant can breathe, cough, or cry or until he stops
responding.
If the Choking
victim becomes
unconscious
Immediately call 9-1-1 and start the CPR
sequence until help arrives.
When completing the ventilations, look
for a foreign object. If seen, remove it.
If not, continue CPR.
Continue until help arrives.