The American Heart Association has updated its 2005 guidelines on cardiopulmonary resuscitation and emergency cardiac care. For CPR, the guidelines newly emphasize chest compressions because of their importance for survival. Among the changes, published in Circulation:
• The order of CPR is now C-A-B (compressions, airway, breathing) instead of A-B-C for everyone except newborns. The first cycle should include 30 compressions before rescue breaths.
• “Look, listen, and feel” is no longer recommended.
• Compressions for adults should be at least (instead of up to) 2 inches and performed at a rate of at least 100 per minute.
• Untrained bystanders should perform compression-only CPR (previous guidelines did not address untrained bystanders separately).
• Emergency cardiac treatments no longer recommended include routine atropine for pulseless electrical activity/asystole, cricoid pressure (with CPR), and airway suctioning for all newborns (exception for those with obvious obstruction).
• New sections address post-arrest care, care for children with cardiac arrest and specific congenital heart defects, and follow-up for children or young adults with sudden, unexplained cardiac death.
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