What are the AHA recommendations for cardiopulmonary resuscitation (CPR) for EMS providers?

Updated: Sep 15, 2020
  • Author: Catharine A Bon, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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The 2015 update includes recommendation for a simultaneous, choreographed approach to the performance of chest compressions, airway management, rescue breathing, rhythm detection, and shocks (if indicated) by an integrated team of highly trained rescuers in applicable settings. [45] Additional recommendations specifically for EMS and other healthcare providers include the following [45] :

  • If the patient is unresponsive with no breathing or only gasping, the patient should be assumed to be in cardiac arrest and the emergency response system should be immediately activated (class I)

  • If a pulse is not definitely felt within 10 seconds, chest compressions should be initiated (class IIa)

  • It is reasonable for healthcare providers to provide chest compressions and ventilation for all adult patients in cardiac arrest, from either a cardiac or noncardiac cause (class IIa) (However, note that chest compression must pause during rhythm analysis by an AED.)

  • Rapid defibrillation is the treatment of choice for ventricular fibrillation of short duration for victims of witnessed OHCA or for IHCA in a patient whose heart rhythm is monitored (class I)

  • For a witnessed OHCA with a shockable rhythm, it may be reasonable for EMS systems with priority-based, multitiered response to delay positive-pressure ventilation for up to three cycles of 200 continuous compressions with passive oxygen insufflation and airway adjuncts (class IIb)

  • Routine use of passive ventilation techniques during conventional CPR for adults is not recommended (class III); in EMS systems that use bundles of care involving continuous chest compressions, the use of passive ventilation techniques may be considered as part of that bundle (class IIb)

  • When the victim has an advanced airway in place during CPR, rescuers need no longer deliver cycles of 30 compressions and two breaths (ie, interrupt compressions to deliver breaths); instead, it may be reasonable for one rescuer to deliver one breath every 6 seconds (10 breaths per minute) while another rescuer performs continuous chest compressions (class IIb)

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