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2010 American Heart Association Guidelines For Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

This document outlines the key changes and recommendations in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. It discusses the fundamental aspects of basic life support including immediate recognition of sudden cardiac arrest, activation of emergency response services, early CPR, and rapid defibrillation. The guidelines emphasize high-quality chest compressions for effective CPR, with a compression to ventilation ratio of 30:2. It recommends "hands-only" CPR for untrained lay rescuers and the use of AEDs for rapid defibrillation. The sequence of CPR emphasizes immediate recognition of SCA and activation of emergency services, early high-quality chest compressions, and rapid

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Ray Sadis
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28 views

2010 American Heart Association Guidelines For Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

This document outlines the key changes and recommendations in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. It discusses the fundamental aspects of basic life support including immediate recognition of sudden cardiac arrest, activation of emergency response services, early CPR, and rapid defibrillation. The guidelines emphasize high-quality chest compressions for effective CPR, with a compression to ventilation ratio of 30:2. It recommends "hands-only" CPR for untrained lay rescuers and the use of AEDs for rapid defibrillation. The sequence of CPR emphasizes immediate recognition of SCA and activation of emergency services, early high-quality chest compressions, and rapid

Uploaded by

Ray Sadis
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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2010 American Heart Association

Guidelines for Cardiopulmonary


Resuscitation and Emergency
Cardiovascular Care
Robert A. Berg, Chair; Robin Hemphill; Benjamin S. Abella; Tom P. Aufderheide;
Diana M. Cave; Mary Fran Hazinski; E. Brooke Lerner; Thomas D. Rea; Michael R.
Sayre; Robert A. Swor

Fundamental

aspects of BLS :

immediate recognition of SCA


activation ERS
early CPR
rapid defibrillation

BLS Guidelines 2010

Key

changed and continued points :

Immediate recognition of SCA unresponsiveness & normal


breathing
look, listen, feel removed
Hands only CPR untrained lay rescuer
ABC CAB
CPR continued ROSC/termination of effort
High quality CPR :

Compression rate & depth


Full chest recoil
Interruption
Avoid overventilation

BLS Guidelines 2010

Key

changed & contiued points :

De-emphasis of pulse check


Simplified algorithm of BLS
Simultaneous & choreographed approach for
resuscitation by integrated trained rescuers

BLS Guidelines 2010 (contd)

leading cause of
Etiologies, circumstances, settings
Single approach to resusc isnt practical ?
universal strategy
Chain of Survival
SCA

Immediate recogniton & activation of ERS


Early CPR chest compression
Rapid defibrilation (indicated)
Effective ALS
Integrated post-SCA care

BLS Guidelines 2010

always straightforward
laypersons
Confusion delay/failure to start CPR
Unresponsive victim immediately
activate the ERS begin CPR
Isnt

Immediate
recognition of
BLS Guidelines 2010
SCA

CPR survival
Often not provided until the arrival of
professional rescuers
The highest priority CHEST
COMPRESSION
Chest compression perfusion during
CPR
push hard & push fast
High quality CPR !!!
Early

BLS Guidelines 2010

Early
CPR

defibrillation predictor of
successful resusc following VF SCA
Reduce interval bw collaps to defibrillation
Depending on the setting & circumstances
Use of AED
AED heart rhythm & lifesaving shock
Rapid

Rapid
Defibrillatio
BLS Guidelines 2010
n

Call

local emergency number


Dispatcher CPR instruction
Misinterpret victims breathing failure
Inquire consciousness & breathing
Unresponsive victim CPR
immediately !!!
Provide hands-only CPR
Include rescue breathing likelihood of
asphyxial (eg, drowning)

Activating
BLS Guidelines 2010
ERS

Sequential

assessments & actions


Easy for any type of rescuers to learn,
remember, and perform
Help a single rescuer to prioritize
EMS/in hospital simultaneously

BLS
BLS Guidelines 2010
Sequence

BLS
BLS Guidelines 2010
Sequence

Immediate Recognition & Activation of


ERS
victim activate the ERS
Absent/abnormal breathing arrest
Dispatcher guide lay-rescuer check
breathing & steps of CPR !!!
ERS activated begin CPR !!!
911 location, the events, number,
condition
Unresposive

BLS
BLS Guidelines 2010
Sequence

Pulse Check
Difficult to detect
Take too long time to check for a pulse
Lay rescuer unresponsive victim
dont check for a pulse !!
Trained no more than 10sec

BLS
BLS Guidelines 2010
Sequence

Early CPR
Chest Compression
Lower

half of the sternum


Intrathoracic pressure & direct compression to
heart blood flow & oxygen delivery
Effective CC providing blood flow during CPR
PUSH HARD & PUSH FAST ~ 2inches/5cm ~
100c/min
Complete Recoil
Minimize frequency & duration of interruption
Compression : Ventilation = 30 : 2

BLS
BLS Guidelines 2010
Sequence

Early CPR
Rescue Breaths
CC started rescue breath m-2-m/bagmask oxygenation & ventilation
Deliver it over 1 sec
Give sufficient tidal volume visible chest
rise

Compression

: ventilation = 30 : 2

BLS
BLS Guidelines 2010
Sequence

Early Defibrillation with an AED


Activating ERS retrieve AED (if nearby &
accessible) return to the victim
1 begin chest
compression

2
rescuers
1 activating ERS
& get AED

Defibrillation

sequence :

Turn the AED on


Follow the AED prompts
Resume compression immediately after the shock
(minimize interuption)

BLS
BLS Guidelines 2010
Sequence

Rescuer Spesific CPR Strategies :


Putting It All Together
Untrained Lay-Rescuer
Provide hands-only CPR PUSH HARD & PUSH
FAST !!!
Follow the directions of dispatcher
Continuously AED arrives/EMS take over care

BLS
BLS Guidelines 2010
Sequence

Trained Lay-Rescuer
Provide chest compression & rescue
breath
Ratio 30 : 2
Continuously AED arrives/EMS
take over care

BLS
BLS Guidelines 2010
Sequence

Healthcare Provider
Provide chest compression & rescue breath
Ratio 30 : 2 advance airway placed
ventilation per 6 to 8 sec
MINIMIZE INTERRUPTION !!!
Suddenly collapse assume as SCA call
AED (if nearby) victim attach&use AED
CPR
Drowning/foreign body obs give 5 cycle ( 2
min) CPR activate ERS

BLS
BLS Guidelines 2010
Sequence

BLS
BLS Guidelines 2010

Skills

Recognition of Arrest (Box 1)


check vics response unresponsive
activate ERS (lays)/check for breath
(trained)
Normal breathing SCA ERS
Deemphasize of checking breath
Occasional gasps
Deemphasize of pulse check
Minimize delays in chest compression

BLS
BLS Guidelines 2010

Skills

Technique : Chest Compression (Box 4)


Firm surface CPR
Kneeling beside the vics chest / standing
beside the bed
Hospital beds backboard
Avoid : delays, interruption, displacement
Heel to heel lower half of sternum
Depth 2 inches (5 cm)
Compression time ~ recoil time

BLS
BLS Guidelines 2010

Skills

Technique : Chest Compression (Box 4)


incomplete recoil
incomplete recoil hemodynamics
Actual no. of CC CC rate + interruption
Interruption : open the airway, rescue breath,
AED analysis
No. of CC/min ROSC
In-hospital : 80c/min; out-hospital : 68-89c/min
Survival 120c/min
Recommended 100c/min
Fatigue

BLS
BLS Guidelines 2010

Skills

Technique : Chest Compression (Box 4)


Fatigue inadequate comp.rate/depth
>>> after 1min of CPR
2/more rescuers switch/2min (5 cycles)
Switch < 5 sec
Lay rescuers do not check for
ROSC !!!
Interruption < 10sec (adv
airway/defibrillator)

BLS
BLS Guidelines 2010

Skills

Compression-Ventilation Ratio (Box 4)


Ratio 30 : 2
Adv. airway dont pause
compression for ventilation !!
Ventilation per 6-8sec (8-10 breaths/min)

BLS
BLS Guidelines 2010

Skills

Hands-Only CPR
Bystander CPR (20-30%) survival
Reluctance to perform m-2-m ventilation
PANIC ATTACK !!
CC > breath O2 level & gas exchange

BLS
BLS Guidelines 2010

Skills

Managing Airway
Open the Airway : Lay Rescuers
Head tilt - chin lift
Open the Airway : Healthcare Provider
Head/neck trauma Head tilt - chin lift
Spinal injury manual spinal motion restriction
Spinal immobilization transport

BLS
BLS Guidelines 2010

Skills

To be continued

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