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Rose Marie Robertson, MD

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One dramatic and often quoted difference is that now the lay-rescuer should not ... This change is based on good data showing that up to 35% of lay-rescuers were ... – PowerPoint PPT presentation

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Title: Rose Marie Robertson, MD


1
New CPR guidelines
  • Rose Marie Robertson, MD
  • President, American Heart Association
  • Professor of Medicine
  • Vanderbilt University Medical Center Nashville,
    Tenn.

2
New CPR guidelines
Reflecting medical science
  • The new CPR guidelines reflect current,
    international standards in resuscitation science.
  • One dramatic and often quoted difference is that
    now the lay-rescuer should not stop to check for
    a pulse.
  • This change is based on good data showing that up
    to 35 of lay-rescuers were wrong when checking
    for a pulse (ie, not finding a pulse when it was
    present, or finding one when it was absent).

3
New CPR guidelines
In lieu of a pulse
  • Cardiopulmonary status can easily be assessed by
    performing simple measures such as looking for
    movement, breathing, coughing, or response to
    stimulation.
  • The patient who responds to rescue breathing does
    not require CPR, and this is a more effective
    measure than checking for a pulse.
  • For medically trained personnel, checking for a
    pulse is still part of the recommendations.

4
New CPR guidelines
Additional changes
  • Lay rescuers performing adult CPR now will
    provide 15 chest compressions for every 2
    breaths, regardless of whether one and two
    rescuers are present.
  • Chest compressions should be administered to an
    adult at 100 per minute.
  • To treat an unconscious adult choking victim, lay
    rescuers will now begin standard CPR including
    chest compressions and will not conduct abdominal
    thrusts or blind finger sweeps of the mouth.

5
New CPR guidelines
Retraining?
  • By July 2001, all training courses will
    incorporate these guidelines.
  • The new guidelines will improve and facilitate
    training. They are easier to remember.
  • Currently certified individuals need not retrain,
    although it will be easier to eventually
    recertify using the new guidelines.

6
New CPR guidelines
Automated external defibrillators
  • In the Heartsaver AED course, participants can be
    trained in CPR and the use of automated external
    defibrillators (AEDs) within 3.5-4 hours.
  • Although CPR is important in buying time,
    getting a defibrillator to the patient, and
    defibrillating quickly are the most important
    lifesaving measures.
  • Of those victims ultimately salvageable, 7-10
    are lost every minute that defibrillation is
    delayed.

7
New CPR guidelines
Potential impact of AEDs
  • Currently, of the 225 000 people who suffer
    cardiac arrest every year in the US, 4-5 are
    saved.
  • By defibrillating more quickly, and increasing
    survival to 20-25, 45 000 to 50 000 additional
    lives would be saved per year.
  • Both CPR and early use of AEDs are links in the
    chain of survival. Additional links include
    early access to emergency care (911 capability)
    and early advanced care with appropriate site
    allocation.

8
New CPR guidelines
Success of CPR
  • Actual success of CPR depends on the cause.
  • Events not requiring defibrillation include
    near-drowning with laryngospasm, or the presence
    of a blocked airway in a conscious choking
    victim.
  • Trainees must learn that they will improve a
    patient's chances of being saved by learning how
    to do CPR appropriately and correctly, but there
    are patients whose lives cannot be saved even
    with timely and appropriate administration of CPR.

9
New CPR guidelines
A source of comfort
  • Family members of patients at risk for future
    adverse ischemic events are greatly reassured
    when they learn CPR.
  • The trainee should realize that he is not just
    learning what to do for people at large, but that
    there are circumstances where he might need to
    use CPR in his own home with his own family.
  • CPR doubles the survival rate, roughly increasing
    a 2-2.5 survival rate to 5, and rates are much
    higher by adding defibrillators.

10
New CPR guidelines
Public access to CPR and defibrillation
  • In Chicago OHare airport, a defibrillator is
    never more than 1 minute away, and 75 of all
    cardiac arrest victims have been saved.
  • Defibrillators should be found in airplanes,
    airports, shopping malls, and sporting venues and
    personnel, such as security guards, should be
    trained to administer CPR.
  • The new guidelines recommend that AEDs be placed
    where there is a reasonable probability of one
    sudden cardiac arrest occurring every 5 years.

11
New CPR guidelines
Resources for CPR training
  • Emergency Cardiovascular Care (ECC) Guidelines
    2000 are published in
  • Circulation
  • Volume 102, Supp 1 August 22, 2000   

CPR training is offered at hospitals and public
agencies. For the nearest access to CPR training,
call 1-877-AHA-4CPR
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