2010 America Heart Association

Guidelines for Cardiopulmonary

Resuscitation and Emergency
Cardiovascular Care

Cardiopulmonary Resuscitation

50th anniversary of modern CPR

50th anniversary of modern CPR

1960 Kouewenhoven, Knickerbocker, Jude:
documented 14 pts who survived cardiac arrest
with the application of closed chest cardiac
massage
1960 Maryland Medical Society: combination of
chest compression and rescue breathing
1962 Direct-current, monophasic waveform
defibrillation
1966 AHA: 1st cardiopulmonary (CPR) guidelines
periodic updates

50th anniversary of modern CPR

During 50 years: early recognition and

activation, early CPR, early defibrillation, and
early access to emergency medical care
save hundreds of thousands of lives around
the world

2010 America Heart Association Guidelines

for Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care

WHATS NEW?

Emphasis on Chest Compressions

2010 (New): If a bystander is not trained in CPR, the
bystander should provide Hands-Only (compression-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. The
rescuer should continue Hands-Only CPR until an AED
arrives and is ready for use or EMS providers or other
responders take over care of the victim.
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 2 breaths. The rescuer should continue
CPR until an AED arrives and is ready for use or EMS
providers take over care of the victim.

 2005 (Old): The 2005 AHA Guidelines for CPR and

ECC did not provide different recommendations for
trained versus untrained rescuers but did
recommend that dispatchers provide compressiononly CPR instructions to untrained bystanders.
The 2005 AHA Guidelines for CPR and ECC did note
that if the rescuer was unwilling or unable to provide
ventilations, the rescuer should provide chest
compressions only.

Change in CPR Sequence: C-A-B

Rather Than A-B-C
2010 (New): Initiate chest compressions before
ventilations.
2005 (Old): The sequence of adult CPR began with
opening of the airway, checking for normal
breathing, and then delivery of 2 rescue breaths
followed by cycles of 30 chest compressions and 2
breaths.

Elimination of Look, Listen, and Feel

for Breathing
2010 (New): Look, listen, and feel was removed
from the CPR sequence. After delivery of 30
compressions, the lone rescuer opens the victims
airway and delivers 2 breaths.
2005 (Old): Look, listen, and feel was used to
assess breathing after the airway was opened.

Chest Compression Rate: At Least

100 per Minute
2010 (New): It is reasonable for lay rescuers and
healthcare providers to perform chest compressions
at a rate of at least 100/min.
2005 (Old): Compress at a rate of about 100/min.

In cardiac arrest, think 'Stayin' Alive'

Debra Bader was taking a walk in the woods with her 53year-old husband one morning when suddenly he
collapsed. At first she thought the situation was hopeless.
"I looked at him and said, 'He's dead,' because he wasn't
moving or making any sounds at all," Bader remembers.
"But I pulled the cell phone out of his pocket and called
911, and then a public service announcement I'd heard on
the radio popped into my head.
The one-minute PSA from the American Heart Association
instructed listeners, in the event of cardiac arrest, to
perform chest compressions very hard to the beat of the
1970s Bee Gees song "Stayin' Alive.
July 02, 2009

Chest Compression Depth

2010 (New): The adult sternum should be
depressed at least 2 inches (5 cm).
2005 (Old): The adult sternum should be
depressed approximately 1 to 2 inches
(approximately 4 to 5 cm).