New CPR Rules: Push Hard, Push Fast
American Heart Association Updates Its CPR Guidelines
Nov. 30, 2005 -- The new rule of thumb for CPR is "push hard, push
So says the American Heart Association (AHA), which has updated its
guidelines for CPR (cardiopulmonary resuscitation), which can double a person's
chances of surviving sudden cardiac arrest.
The new guidelines appear in Circulation.
The most significant change in the new guidelines is the higher number of
recommended chest compressions, states an AHA news release.
The new guidelines call for a lone rescuer to provide 30 chest compressions
for every two rescue breaths. That advice applies to victims of all ages,
except for newborn infants.
The previous guidelines, issued in 2000, called for 15 chest compressions
for every two rescue breaths. If two rescuers are performing CPR, then they are
to follow the previous ratio of 15 chest compressions to two rescue
The change reflects research showing better survival by limiting
interruptions in chest compressions, states the AHA.
The new guidelines also state that lay rescuers (people who aren't trained
medical staff) don't have to check for signs of blood circulation before
beginning chest compressions.
"The lay rescuer will be taught to begin chest compressions immediately
after delivering two rescue breaths to the unresponsive victim who is not
breathing," state the guidelines.
'Easy to Learn'
CPR is "easy to learn and do," says Robert Hickey, MD, in a news
release. Hickey leads the AHA's emergency cardiovascular care programs.
Every year, an estimated quarter of a million unhospitalized people in the
U.S. die of sudden cardiac arrest, write Mary Fran Hazinski, RN, MSN, and
colleagues in an editorial in Circulation.
They add that "despite decades of efforts to promote CPR science and
education, the survival rate for out-of-hospital cardiac arrest remains low
worldwide, averaging 6% or less."
Ready, Willing, and Able
CPR can save lives, and Hickey says the AHA "believes the new guidelines
will contribute to more people doing CPR effectively."
In a news release, the AHA calls for 911 dispatchers to be trained to
provide CPR instruction by phone and to help callers correctly identify victims
of cardiac arrest.
Besides providing the "push hard, push fast" advice, the guidelines
also address issues for emergency medical staff, including the use of
"In the final analysis, the most important determinant of survival from
sudden cardiac arrest is the presence of a rescuer who is trained, willing,
able, and equipped to act in an emergency," write Hazinski and