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Be part of the change

EMS1.com News

October 19, 2010


EMS News in Focus
by Arthur Hsieh

Be part of the change

Editor's note: This article is in response to the story, "New CPR guidelines stress compressions before mouth-to-mouth." It's important that we take note of the new AHA recommendations that everyone from professionals to bystanders who use standard CPR should start first with chest compressions.

As many of you know by now, the American Heart Association released its 2010 Guidelines for emergency cardiovascular care and first aid on Monday. An executive summary of the guidelines can be found here.

Since much of our training and preparation is designed expressly for this area, it's important for us to take note of the changes and begin to think about implementation. For most of us, local protocol changes may take awhile but that doesn't prevent us from considering what medications will need to be learned, or what procedures will be de-emphasized and others introduced. Recognize that there is data to support these changes, all important in an era where every health care dollar counts.

The biggest changes are found in the area of pre-EMS — the public. Building on several years of knowledge, the AHA has changed a fundamental core principle of its resuscitation guidelines for adults. It's no longer the "ABC's"; now it's time to "call a CAB" or Circulation, then Airway and Breathing. For the layperson (and even the professional), someone that has no obvious signs of life needs compressions right away.

It's critical to build coronary artery pressure quickly and maintain that pressure if there is to be an opportunity for the patient to survive cardiac arrest. The blood apparently contains enough oxygen to maintain basic life functions, without the need for artificial ventilations.

As simple as this change may appear, it has accounted for a significant increase in survival rates, especially in the hands of the true first responder— the public. As the next link in the chain of survival, we are the professionals that the public will toward for direction and training in this area.

So, in addition to preparing for the modifications in prehospital care practice, we must also be thinking about how we can get our communities to learn the simple practice of sudden cardiac arrest (SCA) recognition, notification and compression-based CPR. To do so may result in the simplest way to increase survival from SCA, and the single most effective way to improve the overall health of our communities.

In fact, I want to know — are you thinking about it? Are you teaching this now to your community? If so, what barriers have you overcome and how did you do it? Have you seen any changes in survival rates? Tell me below or on Facebook. I bet there are many others out there who are wanting to know.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. In the profession since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a published textbook author, has presented at conferences nationwide, and continues to provide patient care at a rural hospital-based ALS system. Contact Art at Art.Hsieh@ems1.com.
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