1. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care © 2010 American Heart Association. All rights reserved.

2. Key Changes 2010 AHA Guidelines for CPR and ECC Heartsaver CPR/ AED and First Aid © 2010 American Heart Association. All rights reserved.

3. New AHA Adult Chain of Survival New 5th link – post-cardiac arrest care Links in the new adult Chain of Survival: Immediate recognition and activation of emergency response system Early CPR, w/emphasis on chest compressions Rapid defibrillation Effective advanced life support Integrated post-cardiac arrest care © 2010 American Heart Association. All rights reserved.

4. Primary Focus is Chest Compressions ! Can be started immediately (no equipment needed) Opening airway, providing ventilation delay compressions by approx. 18 seconds. All rescuers should, at a minimum, provide chest compressions. If bystander not trained (adult arrest): Hands-Only CPR If bystander trained and able: perform compressions and ventilations at rate of 30:2 © 2010 American Heart Association. All rights reserved.

5. Primary Focus is Chest Compressions at the Proper Rate (TEMPO)! © 2010 American Heart Association. All rights reserved. Audio Cue #1 Audio Cue #2 1) Count out Loud- 1-2-3-4-5-etc 2) Use the Audio Cues

6. Adult Chest Compression Depth Change: Compress at least 2 inches 2005 recommendation was 1½ to 2 inches. Why? Compressions of at least 2 inches are more effective than those of 1½ inches. Rescuers often do not “push hard” enough. Confusion may result when range of depth is recommended. © 2010 American Heart Association. All rights reserved.

7. Chest Compression Rate Change: Compression rate at least 100 per minute. 2005 recommendation: Compression rate about 100/min Why? Actual compression rate is often well below 100/min. © 2010 American Heart Association. All rights reserved.

8. Cricoid Pressure No Longer Recommended Why? Randomized studies have demonstrated that cricoid pressure still allows for aspiration. It is also difficult to properly train providers to perform the maneuver correctly © 2010 American Heart Association. All rights reserved.

9. Elimination of “Look, Listen, and Feel” for Breathing Change: This action removed from the CPR sequence After delivery of 30 compressions, lone rescuer opens airway and delivers 2 breaths. Why? Rescuer checks the following before beginning CPR: A) For response and look at chest for “no breathing or no normal breathing”, B) Check for pulse in adult Starting CPR with compressions minimizes delay to action © 2010 American Heart Association. All rights reserved.

10. C-A-B Sequence for Adults: New science indicates the following order: 1. Check the patient for responsiveness and no breathing. 2. Call for help and get the AED 3. Check the pulse. 4. Give 30 compressions. 5. Open the airway and give 2 breaths. 6. Resume compressions. © 2010 American Heart Association. All rights reserved.

11. Pediatric Resuscitation Revised pediatric chain of survival New post-arrest care link © 2010 American Heart Association. All rights reserved.

13. C-A-B Sequence for Infants: New science indicates the following order: 1. Check the patient for responsiveness and no breathing. 2. Check the pulse. 3. Give 30 compressions. 4. Open the airway and give 2 breaths. 5. Resume compressions. 6. After 2 minutes-Call for help and get the AED © 2010 American Heart Association. All rights reserved.

14. Chest Compressions: Chest compression depth – at least 1/3 of the anterior-posterior diameter of chest Infants: about 1½ inches Children: about 2 inches © 2010 American Heart Association. All rights reserved.

15. AED’s May Now Be Used on Infants

16. First Aid Changes: © 2010 American Heart Association. All rights reserved.

17. First Aid Changes: © 2010 American Heart Association. All rights reserved.

18. Implementing Changes So NOW what??? For each class you will use the following: 2006 Instructor Manual 2006 DVD 2010 Highlights 2010 Skills Sheets C-A-B Sequence Video © 2010 American Heart Association. All rights reserved.

24. Heartsaver Skills Checklist

25. © 2010 American Heart Association. All rights reserved.

27. Science Roll-out (Online Update) Available through AHA Instructor Network Must be registered and confirmed member of AHA Instructor Network to access Four science update courses: ACLS, PALS, BLS (HCP & Heartsaver), Heartsaver-only Timing: Approximately week of December 8, 2010 Will be staggered release – not all Instructors will receive simultaneously Notifications sent to batches of AHA Instructors over the course of 1-2 weeks

28. Interim Training Materials Available (to view and download) through AHA Instructor Network Must be registered and confirmed member of AHA Instructor Network to access Materials for each discipline Timing: Will be posted when Online Update is available to first batch of notified Instructors Instructors should complete Online Update prior to using Interim Materials

29. Interim Training Materials Available (to view and download) through AHA Instructor Network Must be registered and confirmed member of AHA Instructor Network to access Materials for each discipline Timing: Will be posted when Online Update is available to first batch of notified Instructors Instructors should complete Online Update prior to using Interim Materials

30. Questions ????????? © 2010 American Heart Association. All rights reserved.