Every five years, the International Liaison Committee on Resuscitation update their recommendations for CPR and First Aid. The most recent changes are relatively minor, but important.
For any unconscious patient, always call 9-1-1 and for an AED to be brought to the patient’s side.
The first update relates to when a healthcare provider is assessing a patient for responsiveness. Healthcare providers should check for breathing and pulse at the same time. Breathing is best detected by looking for observable chest rise. Agonal breathing, or gasping should not be considered adequate breathing and should be treated as apnea. Simultaneously, place two fingers in the groove formed by the trachea and sternocleidomastoid muscle, on the same side you are kneeling. If you are sure you’ve found a pulse, then healthcare providers should perform rescue breathing. In the absence or uncertainty of a pulse, start CPR beginning with chest compresions.
Good Samaritans and non-medically trained persons should look only for breathing and begin chest compressions in the absence of breathing. It is far better to give compressions when someone does not need them than to not give compressions when he or she does.
While ventilation is still recommended, it is acceptable to withhold breaths if there is no barrier device available, or if the rescuer is uncomfortable doing so. Remember, in the first few minutes of cardiac arrest, it is far more important to circulate blood that is losing oxygen than to oxygenate blood that is not circulating.
The second change is the rate of compressions. While the 2010 guidelines stated that compressions should be given at a rate of “at least 100 per minute”, the 2015 guidelines call for an upper limit of 120 per minute. Research shows that when rescuers give compressions faster than 120 per minute, they tend to not allow for full chest recoil which allows the heart to fill with blood before it is squeezed again.
The third change is in the depth of compressions. The 2010 guidelines called for compressions to be “at least 2 inches or 5 cm” in depth. In 2015 an upper limit of 2.4 inches was placed on the compression depth. It is thought that additional injury was inflicted to victims who received the deepest compressions. There is no recommendation, however, for how to measure the compression depth in the absence of a feedback device.