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AMERICAN HEART ASSOCIATION CHANGES IN THE 2010 CHANGES IN THE 2010 GUIDELINES AFFECTING ALL GUIDELINES AFFECTING ALL RESCUERS RESCUERS AMERICAN HEART AMERICAN HEART ASSOCIATION ASSOCIATION
AMERICAN HEART ASSOCIATION
CHANGES IN THE 2010 CHANGES IN THE 2010 GUIDELINES AFFECTING GUIDELINES AFFECTING
ALL RESCUERSALL RESCUERS
AMERICAN HEART AMERICAN HEART ASSOCIATIONASSOCIATION
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Health Care Provider* “PUSH HARD AND PUSH FAST”
At least 100 COMPRESSIONS / MINUTE*
Allow the chest to recoil -- equal compression and relaxation times
<10 seconds for pulse checks or rescue breaths
Compression Depth* Adults 2”
Child/Infant 1/3 depth of chest 1.5" infant 2" child
Avoid excessive ventilations
A-B-C changed to C-A-B*
Critical element is chest compressions Delay in A-B
Avoidance of A & B
Early defib
If alone--call and retrieve AED Exception asphyxial arrest
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
• Cricoid pressure not recommended
• Advanced airway = 1 every 6-8 seconds• Adult: 1 every 5-6 Peds: 1 every 3
• With advanced airway- no pause
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Dispatcher Identification
• SCA = seizure & agonal gasps• Trained to ID – ask if breathing is
normal• Only gasping???• Provide CPR instructions
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
AHA ECC Adult Chain of Survival - New
• Lay Rescuer – Hands-only CPR (untrained vs trained)
– Easier
– Guided by dispatchers
– SR are same
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Simplified Universal BLS algorithm
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Electrical Therapies• Shock first vs CPR first• No precordial thump• CPR devices – no data for• AED in hospital (goal to shock =< 3 mins)
• Use in infants (with or without attenuator)
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
ACLS• Simplified algorithm• Optimized CPR quality with monitoring• Waveform capnography (>12 mmHg)• Atropine deleted (PEA/Asystole)• Chronotropic drugs for brady, then pacing• Adenosine safe for monomorphic wide tachs• Post-cardiac arrest
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
AMERICAN HEART ASSOCIATIONAMERICAN HEART ASSOCIATIONCAPNOGRAPHY
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Post-Cardiac Arrest – ROSC•Therapeutic Hypothermia
– Remain comatose
– 32-34 degree C (all ages) (89.6-93.2 F)
– 12-24 hours
•PCI
•O2 sat ≥94% & PETCO 35-40
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
• Asthma
• Anaphylaxis
• Pregnancy
• Morbid obesity
• PE
• Electrolyte imbalance
• Toxins
Special Resuscitation Situations
• Hypothermia
• Avalanche
• Drowning
• Electric shock/lightening
• PCI
• Cardiac tamponade
• Cardiac surgery
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Acute Coronary Syndromes•Out of hospital 12-lead•Triage to PCI•Oxygen – > 94 % is the goal (capno)•Morphine – use with caution in UA/non-STEMI
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Stroke•Stroke-prepared hospitals
•Triage to stroke centers
•TPA up to 4.5 hours
AMERICAN HEART ASSOCIATION:AMERICAN HEART ASSOCIATION:2010 GUIDELINES2010 GUIDELINES
Learning to Mastery
•New CPR Prompts devices
•Online training: http://www.onlineaha.org/
•Instructor network http://ahainstructornetwork.americanheart.org/AHAECC/ecc.jsp?pid=ahaecc.signin&_requestid=133687
