October 15, 2015After a five-year hiatus, the American Heart Association (AHA) has updated its CPR and ECC guidelines. Emphasize how to achieve rapid action, reasonable training, use of modern technology, and team collaboration to increase the survival rate of cardiac arrest patients.

1Purpose:

Every year, over 326000 people experience out of hospital cardiac arrest, with approximately 90% of patients ultimately dying. Rapid and effective cardiopulmonary resuscitation can effectively avoid the mortality rate of cardiac arrest patients.

2、 Key updates and sorting

The AHA adult survival chain is divided into two chains: one is the in-hospital emergency system, and the other is the out of hospital emergency system;

In the era of mobile phones, making full use of social media to call rescuers, modern electronic devices such as mobile phones can play an important role;

3. Implement cardiopulmonary resuscitation in a team format: early warning system, rapid response team (RRT), and emergency medical team system (MET).

3、 What should non professionals do

1. Continue to emphasize the simplified universal adult basic life support (BLS) process;

2. The rescuer should respond urgently without leaving the patient (through electronic devices such as mobile phones), and untrained bystanders should immediately provide first aid (120 in China);

3. It is recommended to implement a public place defibrillator (PAD) program in communities where there is a risk of cardiac arrest. Defibrillators can be equipped in communities, gyms, sports fields, and other places;

4. Encourage non professionals to perform cardiopulmonary resuscitation (CPR): quickly identify cardiac arrest and immediately provide CPR guidance to callers (CPR guided by dispatchers);

5. The rescue sequence of a single rescuer: chest compressions should be started first before artificial respiration (C-A-B) to reduce the delay of compressions;

6. Non professionals should perform Hands Only cardiopulmonary resuscitation on adult patients with cardiac arrest under guidance, and instruct automatic external defibrillators or trained rescuers to perform chest compressions; No need for mouth to mouth resuscitation, only perform rapid and powerful compressions in the center of the chest at a frequency of 100-120 times per minute. If capable, artificial respiration should be given in a ratio of 2 breaths per 30 compressions.

7. High quality cardiopulmonary resuscitation with sufficient rate and compression amplitude: compression rate of 100-120 times/minute; The amplitude should be at least 2 inches (5 centimeters). Not exceeding 2.4 inches (6 centimeters);

8. Patients with suspected life-threatening conditions or emergency situations related to opioid drugs should be given naloxone: naloxone treatment should be administered under the guidance of relevant personnel.

4、 What should professionals do

Table 1 Precautions for high-quality cardiopulmonary resuscitation in adults in BLS

Table 2 Summary of Key Points for BLS Personnel to Perform High Quality CPR

1. Basic principle: The rescuer should perform several steps simultaneously, such as checking breathing and pulse, to shorten the time to start pressing;

Multiple rescuers form a comprehensive team and complete multiple steps and evaluations simultaneously (including implementing emergency response systems, chest compressions, ventilation or obtaining balloon masks for artificial respiration, retrieving the patient and setting up defibrillators);

2. High quality cardiopulmonary resuscitation

（1）. After each compression, the chest should fully rebound, and the rescuer must avoid leaning on the patient's chest during the compression interval;

（2）. Reduce compression interruption: The target proportion of chest compressions in overall cardiopulmonary resuscitation should be at least 60%;

（3）. If the emergency medical system adopts comprehensive treatment intervention including continuous chest compressions, passive ventilation technology can be considered for out of hospital cardiac arrest patients in comprehensive treatment;

（4）. For patients undergoing continuous cardiopulmonary resuscitation with airways, it is recommended to simplify the ventilation rate to one breath every 6 seconds (10 breaths per minute).

3. Sufficient speed and compression amplitude: The compression rate is 100-120 times/minute; The amplitude should be at least 2 inches (5 centimeters). Not exceeding 2.4 inches (6 centimeters). The data suggests that the rate and depth of excessive compression have a worse emergency effect, so the guidelines have set upper limits for the depth and rate of cardiac compression.

4. In terms of target temperature management to help patients prevent brain degeneration and damage, evidence shows that the temperature range can be expanded to 32-36 degrees Celsius and maintained for at least 24 hours

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Standard: Updated 201HA cardiopulmonary resuscitation guidelines

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