CHICAGO - More than 1,800 EMS Providers, instructors, AHA faculty and managers, gathered this morning at the McCormick Center in Chicago for the 2010 American Heart Association Instructor Update.
Representatives from all 50 U.S. States and 30 other countries are in attendance to review the new AHA CPR Guidelines and hear what's new, removed or modified in the 2010 CPR and ACLS Guidelines.
A.J Heightman, JEMS Editor-in-Chief, in attendance at the AHA CPR Instructor Update Conference in Chicago, provided these highlights and key points from this mornings Guidelines Summary Session.
1) The LOOK, LISTEN and FEEL step has been eliminAted so there is no delay in getting on the chest and doing compressions.
2) Agonal breaths will be considered to be the same as no breaths - so there is no delay in the start of compressions.
3) Research has shown that, when CPR was minimally interrupted, there a significant increase in resuscitations.
4) There is a new link in the Chain of Survival - a link that ensures that systems integrate quality post-cardiac care into the chain.
5) We want to start CPR early and avoid breaths because, in the early moments of a cardiac arrest, the heart is adequately oxygenated.
6) Researchers have found that bystanders were willing to do CPR, but have not been sure what to do. Papers published recent show no difference in outcome between breath CPR and compression-only CPR. And, twice as many patients have been resuscitated after receiving bystander CPR versus no intervention.
Experts therefore believe going to compressions-only CPR will increase the number of citizens who get involved in the delivery of care.
7) Pediatric patients still do better (5 times better) with conventional CPR provided by bystanders.
8) Chest compressions are critical and must be "at least 2" in depth for all adults and "at least" delivered at 100 per minute. For children and infants, the depth is to be "at least 1/3 the depth compared to the total circumference of the chest.
9) Half of all children found in cardiac arrest have been found to have an underlying condition, so the Guidelines call for 30:2 sequences for children.
10) Personnel have to practice like a Formula One pit crew to deliver the best and most efficient CPR/ACLS.
11) Simulation and CPR feedback devices are now recommended and have been shown to be very effective in improving resuscitation performance.
12) Mechanical CPR devices may now be considered "when conventional CPR would be difficult to maintain".
13) Atropine is out for v fib and asystolic cardiac arrest.
14) Impedence Threshold Device (ITD) use (such as the ResQPod) is allowed.
15) STEMI Systems, 12-Lead ECG use, Continuous Waveform Capnography and Therapeutic Hypothermia (TH) are recommended.
16) O2 delivery should be titrated to 94-98%.
17) You can begin resuscitation with room air (versus O2) on newborn, term infants and use therapeutic hypothermia on full term infants.
18) In the area of First Aid, the use of tourniquets in the field is again recommended for prehospital crews.
Watch for special editorial reports and supplements in December and January's issues of JEMS.