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AMERICAN HEART ASSOCIATION

AMERICAN HEART ASSOCIATION. AMERICAN HEART ASSOCIATION. CHANGES IN THE 2010 GUIDELINES AFFECTING ALL RESCUERS. AMERICAN HEART ASSOCIATION: 2010 GUIDELINES. Health Care Provider* “PUSH HARD AND PUSH FAST” At least 100 COMPRESSIONS / MINUTE*

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AMERICAN HEART ASSOCIATION

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  1. AMERICAN HEART ASSOCIATION AMERICAN HEART ASSOCIATION CHANGES IN THE 2010 GUIDELINES AFFECTING ALL RESCUERS

  2. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Health Care Provider* • “PUSH HARD AND PUSH FAST” • At least 100 COMPRESSIONS / MINUTE* • Allow the chest to recoil -- equal compression and relaxation times • <10 seconds for pulse checks or rescue breaths • Compression Depth* • Adults 2” • Child/Infant 1/3 depth of chest 1.5" infant 2" child • Avoid excessive ventilations

  3. AMERICAN HEART ASSOCIATION:2010 GUIDELINES • A-B-C changed to C-A-B* • Critical element is chest compressions • Delay in A-B • Avoidance of A & B • Early defib • If alone--call and retrieve AED • Exception asphyxial arrest

  4. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Cricoid pressure not recommended Advanced airway = 1 every 6-8 seconds Adult: 1 every 5-6 Peds: 1 every 3 With advanced airway- no pause

  5. Dispatcher Identification • SCA = seizure & agonal gasps • Trained to ID – ask if breathing is normal • Only gasping??? • Provide CPR instructions

  6. AMERICAN HEART ASSOCIATION:2010 GUIDELINES AHA ECC Adult Chain of Survival - New

  7. AMERICAN HEART ASSOCIATION:2010 GUIDELINES • Lay Rescuer – Hands-only CPR (untrained vs trained) • Easier • Guided by dispatchers • SR are same

  8. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Simplified Universal BLS algorithm

  9. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Electrical Therapies • Shock first vs CPR first • No precordial thump • CPR devices – no data for • AED in hospital (goal to shock =< 3 mins) • Use in infants (with or without attenuator)

  10. AMERICAN HEART ASSOCIATION:2010 GUIDELINES ACLS • Simplified algorithm • Optimized CPR quality with monitoring • Waveform capnography(>12 mmHg) • Atropine deleted (PEA/Asystole) • Chronotropic drugs for brady, then pacing • Adenosine safe for monomorphic wide tachs • Post-cardiac arrest

  11. AMERICAN HEART ASSOCIATION CAPNOGRAPHY

  12. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Post-Cardiac Arrest – ROSC • Therapeutic Hypothermia • Remain comatose • 32-34 degree C (all ages) (89.6-93.2 F) • 12-24 hours • PCI • O2 sat ≥94% & PETCO 35-40

  13. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Special Resuscitation Situations • Asthma • Anaphylaxis • Pregnancy • Morbid obesity • PE • Electrolyte imbalance • Toxins • Hypothermia • Avalanche • Drowning • Electric shock/lightening • PCI • Cardiac tamponade • Cardiac surgery

  14. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Acute Coronary Syndromes • Out of hospital 12-lead • Triage to PCI • Oxygen – > 94 % is the goal (capno) • Morphine – use with caution in UA/non-STEMI

  15. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Stroke • Stroke-prepared hospitals • Triage to stroke centers • TPA up to 4.5 hours

  16. AMERICAN HEART ASSOCIATION:2010 GUIDELINES Learning to Mastery • New CPR Prompts devices • Online training: http://www.onlineaha.org/ • Instructor network http://ahainstructornetwork.americanheart.org/AHAECC/ecc.jsp?pid=ahaecc.signin&_requestid=133687

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