Simpler CPR Instruction, More Emphasis on AED Use

Do you feel like you will never remember all of those compression to breath ratios? Do you walk out of a CPR class scared out of your mind, wondering, 'what if I get it all wrong in an actual emergency?' Well, evidently you are not alone. Therefore, the CPR powers that be have recently approved the new CPR instructions. Over the last 10 years or so these standards setting organizations have gradually simplified the guidelines for CPR and other first aid skills. They have come to understand that in CPR too, simpler is better. The easier the CPR instructions are the more confident lay providers will be in performing them.

A second outcome of the new 2005 CPR instructions is a greater emphasis on the use of automatic external defibrillation (AED) systems. Numerous studies show that survival rates see a significant spike upward in environments where an AED is readily available and responders are trained in their use. In most situations it is defibrillation, not CPR that brings someone out of sudden cardiac arrest. So, a greater emphasis on early and greater use of AED is a logical and welcome change.

So, what has changed you ask? Here is a breakdown of the major CPR instruction changes:

Procedure	Old Guideline	New Guideline	Reason for Change
Opening An Airway	Use a head tilt-chin lift if patient is uninjured. Use a jaw thrust if injury to back or neck is suspected	Use a head tilt-chin lift in all situations	It is difficult for lay providers to perform the jaw thrust without moving the spine. Also, the head tilt-chin lift is more effective. In the unlikely event that a neck injury is present, an open airway is still a higher priority of care.
Rescue Ventilations	If normal breathing is not present take a deep breath and deliver two ventilations. Ventilations should be 1 1/2 to 2 seconds in length for adults and 1 to 1 1/2 seconds in lenth for infants and children. Check for signs of circulation. If present, but patient is still not breathing perform rescue breathing.	If normal breathing is not present take anormal breath and deliver two ventilations. Ventilations should be1 second in length for all ages. Adults if normal breathing is not present in an adult, give two ventilations and start CPR beginning with compressions.Rescue breathing will no longer be taught to the lay rescuer in coming to the assistance of an adult patient.	Taking a normal before ventilations will prevent a rescuer from becoming light-headed. It will also help prevent complications of air getting in the stomach during ventilations. Current evidence gives greater importance on the need for quality compressions during CPR. Shortening ventilation time will result in a shorter interruption between compressions. Adults Lack of normal breathing in adults is a good indicator of sudden cardiac arrest. Additionally, evidence shows that it is often difficult for lay providers to adequately assess signs of circulation.
Chest Compressions	During CPR, use a 15:2 compression to ventilation ratio for an adult; use a 5:1 compression to ventilation ratio for infants and children.	During CPR, use a 30:2 compression to ventilation ratio for all ages.	Frequent interruption of chest compressions significantly decreases blood flow in the circulatory system. A higher number of consecutive compressions will improve blood flow to the brain and other internal organs. Additionally, a universal compression to ventilation ratio of 30:2 will be easier to remember for the lay provider.