2015 CPR Guidelines

What to Do Based on the Best Science Available

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On October 15, 2015, the American Heart Association (AHA), in coordination with the International Liaison Committee on Resuscitation (ILCOR) issued updated guidelines for cardiopulmonary resuscitation and emergency cardiac care.

The guidelines for treatment of sudden cardiac arrests and other cardiac emergencies are based on a review process of all the available published research coupled with input from resuscitation experts from around the world. These committees release their findings and issue their recommendations generally every 5 years.

Probably the most interesting update in the 2015 Guidelines over the 2010 CPR Guidelines is the focus on using smartphone apps. The authorities are really singing the praises of various apps intended to summon help and to coach the rescuer on proper technique.

Adult CPR Changes

In 2015, not too much changed in adult CPR from the 2010 Guidelines, as far as the mechanics go. The sequence remains C-A-B rather than A-B-C. Lay rescuers are still encouraged to perform Hands Only CPR if they find an adult who is not responding and not breathing normally.

Like the 2010 Guidelines, the 2015 Guidelines emphasize the importance of proper CPR if the rescuer has been trained and is willing to do the full Monty. I reiterate (and so does the AHA) that something is better than nothing. So, if you aren't sure what to do, call 911 and push on the chest.

Two new recommendations for 2015 include limits on how fast and how deep compressions should be. The rate restriction makes sense to me. Rather than saying compressions should be performed at a rate of at least 100 per minute, the 2015 Guidelines say that compressions should stay between 100 and 120/minute. It turns out that going too fast results in reduced blood flow, which of course is the point of the whole thing.

I'm not as in love with the depth restriction. In the 2015 Guidelines, the AHA recommends a depth of at least 5 cm and no more than 6 cm. Not only is that nearly impossible to measure as a professional--let alone as a lay rescuer--but it is based on only one study of questionable value. In that one study, patients might have had some damage caused by pushing too deep.

Pediatric CPR Changes

Very little has changed in the 2015 CPR Guidelines for children and infants. Kid CPR is rare enough and delicate enough that little research is done on these tiny ones.

One important note that I wanted to make: breathing is important in kids. Cardiac arrest in children is so often related to asphyxia. It's extremely important if you have children to learn CPR for their well-being. That said; if you don't know proper CPR, start with what you know and send in the troops.

Don't Hesitate to Act

The most important recommendation the AHA or I can make to you is: do something.

It's extremely common for 911 centers to have folks call 911 and ask the dispatcher which steps are the right steps to take in CPR. Don't wait. Call 911 for sure, but put your phone on speaker and get started pushing on the chest. There's no reason to wait for someone else.

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Article Sources

  • Neumar RW, et al. "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Circulation. 2015 Nov 3;132(18 Suppl 2):S315-67. doi: 10.1161/CIR.0000000000000252.