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Cardio Diabetes Medicine 2017 483

Newer Guidelines on Cardiac Arrest in Nutshell

Dr.S.Senthilkumaran, M.D, Dip.A&E, FCCM (Aus), Ph.D,

Chief of Medical Service, Be Well Hospitals, Erode.

Emphasis on Chest Compressions or CPR with both compressions and rescue breaths
Untrained lay rescuers should provide compres- when provided before EMS arrival. However, for the
sion-only (Hands-Only) CPR, with or without dis- trained lay rescuer who is able, the recommendation
patcher guidance, for adult victims of cardiac arrest. remains for the rescuer to perform both compres-
The rescuer should continue compression-only CPR sions and breaths.
until the arrival of an AED or rescuers with additional C-A-B Sequenced
training. All lay rescuers should, at a minimum, pro-
vide chest compressions for victims of cardiac arrest. 2015 (Updated):
In addition, if the trained lay rescuer is able to per- Although the amount and quality ofsupporting data
form rescue breaths, he or she should add rescue are limited, it may be reasonable to maintainthe se-
breaths in a ratio of 30 compressions to 2 breaths. quence from the 2010 Guidelines by initiating CPR-
The rescuer should continue CPR until an AED arrives with C-A-B over A-B-C. Knowledge gaps exist, and
and is ready for use, EMS providers take over care specificresearch is required to examine the best se-
of the victim, or the victim starts to move.
quence for CPRin children.
2010 (Old):
2010 (Old):
If a bystander is not trained in CPR, the bystander Initiate CPR for infants and children with
should provide compression-only CPR for the adult chest compressions rather than rescue breaths
victim who suddenly collapses, with an emphasis to
“push hard and fast” on the center of the chest, or (C-A-B rather than A-B-C). CPR should begin with 30
follow the directions of the EMS dispatcher. compressions (by a single rescuer) or 15 compres-
sions rather than with 2 ventilations.
The rescuer should continue compression-only CPR
until an AED arrives and is ready for use or EMS pro-
viders take over care of the victim. All trained lay res- Why
cuers should, at a minimum, provide chest compres- In the absence of new data, the 2010 sequence has
sions for victims of cardiac arrest. In addition, if the not been changed. Consistency in the order of com-
trained lay rescuer is able to perform rescue breaths, pressions, airway, and breathing for CPR in victims of
compressions and breaths should be provided in a all ages may be easiest for rescuers who treat people
ratio of 30 compressions to 2 breaths. The rescu- of all ages to remember and perform. Maintaining the
er should continue CPR until an AED arrives and is same sequence for adults and children offers consis-
ready for use or EMS providers take over care of the tency in teaching.
victim.
Why: Compression-only CPR is easy for an untrained Chest Compression Rate\
rescuer to perform and can be more effectively guid- 2015 (Updated):
ed by dispatchers over the telephone. Moreover, sur-
vival rates from adult cardiac arrests of cardiac eti- In adult victims of cardiac arrest, it is reasonable for
ology are similar with either compression only CPR

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