[New guidelines of Basic and Advanced Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC) American Heart Association (AHA)].
New American Heart Association Guidelines 2010 emphasize the need for high-quality CPR, which can be seen in initiating chest compressions sooner (before 2 ventilations) and with slightly modified compression depth and rate. Fundamental change in CPR sequence is abandoning A-B-C steps for C-A-B (all age groups excluding newly born) to minimise the delay in initiating chest compressions. Dispatchers should help bystanders recognize cardiac arrests and provide instructions on Hands-Only CPR. New guidelines add fifth link to the Adult Chain of Survival - "post-cardiac arrest care" and underline team approach to the resuscitation. Advanced Cardiovascular Life Support guidelines also emphasize good-quality CPR and recommend capnography for monitoring CPR quality. Atropine is no longer recommended for routine use in the treatment of pulseless electrical activity and asystole. For symptomatic bradycardia pacing is still recommended but chronotropic drug infusions should be considered an alternative. Both morphine and oxygen should be used with caution in acute coronary syndromes as they might affect the outcome. Post-cardiac arrest care after ROSC should include multidisciplinary management and often includes hypothermia.
Zakład Medycyny Katastrof Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu. agata-rat-med@o2.pl
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D000572:American Heart Association; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D004632:Emergency Medical Services / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic; D014481:United States