New guidelines change CPR procedures

  • Published
  • By Staff Sgt. Terri Barriere
  • 2nd Bomb Wing Public Affairs
BARKSDALE AIR FORCE BASE, La. --  In compliance with scientific changes found in 2010, the new American Heart Association guidelines for Cardiopulmonary Resuscitation went into effect April 1, and Airmen assigned to the Air Force Global Strike Command at Barksdale will soon notice those changes in certification training.

However, according to Capt. Darrell Sanders, 2nd Medical Group, those already certified should not panic.

"If you are a current CPR card holder and your certification has not expired you will continue to perform CPR according to the standards you were trained under," he said.

The captain said there are a number of significant changes in CPR:

The first change trainees might notice is a change in the basic life support sequence of steps for trained rescuers from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults and pediatric patients (children and infants, excluding newborns). This also applies to BLS for healthcare providers.

In the majority of cardiac arrests, the critical initial elements of CPR are chest compressions and early defibrillation. In the C-A-B sequence, chest compressions will be initiated sooner and ventilation only minimally delayed until completion of the first cycle of chest compressions. The A-B-C sequence could have been a reason why less than a third of people in cardiac arrest received bystander CPR. A-B-C started with the most difficult procedures: opening the airway and delivering rescue breaths.

The second change trainees will notice is the absence of the steps "Look, Listen and Feel," according to Captain Sanders it was determined to be inconsistent and time consuming.

Changes were also made to the compression rate, under the new guidelines, the new compression rate is at least 100 compressions per minute.

According to Captain Sanders, the number of chest compressions delivered per minute during CPR is an important determinant of return of spontaneous circulation and survival with good neurologic function. In most studies, delivery of more compressions during resuscitation is associated with better survival, and delivery of fewer compressions is associated with lower survival.

New compression depths were also established, and are as follows: 2 inches (5cm) for adults, 1/3 the depth of the chest, approximately 2 inches (5cm) for children and at least 1/3 the depth of the chest, approximately 1 ½ inches (4cm) for infants.

"Compressions generate critical blood flow and oxygen and energy delivery to the heart and brain. Rescuers often do not push the chest hard enough," said Captain Sanders.

Finally, Captain Sanders said if a bystander is not trained in CPR, the bystander should provide hands-only CPR for the adult victim who suddenly collapses, with an emphasis to push hard and fast on the center of the chest, or follow the directions of the EMS dispatcher. All trained lay rescuers should, at a minimum, provide chest compressions for victims of cardiac arrest. In addition, if the trained lay rescuer is able to perform rescue breaths, compressions and breaths should be provided in a ratio of 30 compressions to two breaths.

"Hands-only (compression-only) CPR is easier for an untrained rescuer to perform and can be more readily guided by dispatchers over the telephone. In addition, survival rates from cardiac arrests of cardiac etiology are similar with either hands-only CPR or CPR with both compressions and rescue breaths. However, for the trained lay rescuer who is able, the recommendation remains for the rescuer to perform both compressions and ventilations," he said.

"Hopefully, the information provides some insight into to the new American Heart Association guidelines for Cardiopulmonary Resuscitation," said Captain Sanders.

For more information regarding CPR training, contact the 2 MDG, Education and Training Office at 456-6997 or contact unit or squadron training or deployment managers.