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Readers Respond: Thoughts on the 2010 CPR Guidelines

Responses: 19


Updated October 10, 2010

From the article: 2010 CPR Guidelines

The 2010 CPR Guidelines have been released by the American Heart Association. What do you think? Do you like the new guidelines? Do you hate them?

Share your thoughts on the 2010 CPR Guidelines and read what others have to say about them.

er specialest

i dont know if its fair to say CAB in wetness cpr and ABC in unweetness cpr
—Guest Dr Basel


I think the CAB principal will be effective if you actually see the person falling down right infront of you then it means you were there and the person probably still has enough oxy. in his lungs and blood for you to start with CAB, but if you respond and have to drive to the scene then the original ABC will be much more effective!!!
—Guest Sylvi

No Head Tilt? No Look Listen and Feel?

Having been an EMT-CC for years, I am concerned about not starting with ABC. Many of us have had or heard of patients being saved with just a simple head tilt. And let's face it...chest compressions seperate the ribs from the sternum. So we are going to 'bust ribs' before we open the airway...hmmmm. Lastly, for a reticent lay person, doing these rib-crunching compressions will be just as icky as opening the airway etc etc. I don't know that skipping the airway step will entice people to crunch ribs.
—Guest Ann


This is a long time coming. I deal with the public and unless you make C.P.R. easy, people may not or will not perform due to fear of error.
—Guest Nurse Mimi

Make the diffrence with pulse

I think now its the only way to make a diffrence of a problem with breathing and a cardiac arrest is measuring the pulse. With the logic of a Cardiac arrest the ventilation in the lungs was taken place and the blood is filled with oxygen. I think when the person becomes cyanotic (blue) then I sould think of a lung problem.
—Guest Daan


If pt.`s airway is not clear and he is not breathing his blood is oxygen defficient. Then chest compressions will push blood to the brain but without oxygen. So i think it is useless to do chest compressions without providing oxygen to the lungs. But the changes made in the recent guidelines should be followed and then we should make any inference.
—Guest OM

I don't get it...

It just seems nuts to me. We have all seen the patient who appears to not be breathing and simply better opening the airway results in a big breath – all good! Now it seems we will be starting chest compressions and leaving the airway compromised. I have seen and felt ribs break, especially on elderly patients – why would anyone risk that kind of damage on a patient who may be simply in need of an open airway? I can see how the new standard may possibly be suited to untrained lay people in the street but really does this apply to pre-hospital care trained personnel?
—Guest Chris

Confused as well

Chris, I had the same question, I'm a college student aspiring to be a physical therapist dually certified in athletic training. I took a first aid course for an easy A because I've been taking first aid courses since my freshman year in high school. My professor just assigned us to review the new AHA guidelines: http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S676 and write a report on the new changes. I am currently still waiting for her to respond to my email regarding the same question as yours. It doesn't make any sense to begin compressions without assessing if the victim is breathing already. I do agree with you with your assess quickly then CAB.
—Guest Ashley


c-a-b is really very much important for CPR , ths information save many lifes.
—Guest geetanjali

Why is everyone agreeing with this stuff

The excuse that rescuers are taking too long to get past the ick factor is rediculous, CPR is tought to be done ONLY when using a barrier device. A breathing check and delivery of two initial breath should take no longer than 20 seconds. Rescuers who do not have a barrier device should be doing compression only CPR. As that what the current standards suggest. Bob - To respond to your comments, unwitnessed cardiac arrest, or cardiac arrect in young adult and children is often cause by a breathing related emergency, and the casualties need to rescue breaths to introduce some oxygen into their system.
—Guest Chris

Why is everyone agreeing with this stuff

The new heart and stroke foundation guidelines make no logical sence to me as an instructor. Here is an exert from the new AHSF 2010 cpr guidelines: "In previous guidelines, the association recommended looking, listening and feeling for normal breathing before starting CPR. Now, compressions should be started immediately on anyone who is unresponsive and not breathing normally." Unresponsive and not breathing normally... meaning we need to be able to assess breathing before beginning CPR. There are many poeple who are unresponsive and breathing... do we do 30 chest compressions on them, before we determine their breathing? That seems like putting a casualty at unnecessary risk of breaking ribs and bruising the heart.. I could understand the new changes if they stressed the steps are as follows "Assess the scene for safety, asses the casualties responsiveness, assess the casualties breathing, if breathing is not present THEN do C-A-B. Which is how CPR is essentially done already.
—Guest Chris


I see little thinking in the guidelines from the committee in following the science of CPR - which is what this discussion here is all about. What is so great about the thinking of a group of scientists who disregarded the validity of the studies showing uninterrupted chest compressions is twice as effective as compressions interposed with ventilations, every 30 seconds? Not that I question the thinking ability of the individual committee members. I think what happened is political and peer pressure tainting the minds of some otherwise very capable scientists. In fact, I have read papers of the committee members which reflect the research in the light of hands only CPR. Hopefully, we will see some recanting of these guidelines in the near future to more accurately guide CPR instructors like yourself and the layman and professionals as well. This is a very important issue with thousands of lives at stake.
—Guest bob beasley


The new AHA guidelines are shameful. Here's why: The vast majority of studies on CPR show that uninterrupted chest compressions are twice as effective as compressions with ventilations. Yet the AHA would have us performing 30 compressions; stop; open the airway; and give two breaths, then repeat this pattern of 30:2 thereafter. The problem is that with each of the interruptions for ventilation, cerebral and coronary blood flow stops dead still for approximately 12 - 18 seconds. In addition, when compressions are resumed it takes still more time to regain the hemodynamic pressure head that was achieved during the compressions, but lost during the ventilations. Not only are the preceding negative events occurring, but the inflation of the lungs during ventilations increases intrathorasic pressure which, in turn, decreases venous return, and thus stroke volume in subsequent compressions. In my opinion the guidelines should read A.C.P.R.S. See www.handsonwounds.com for details.
—Guest bob beasley




I agree to the latest guidelines recommended by AHA,. giving 30 compressions instead of more, as an initial action given to the victim of cardiac arrest is enough especially to those healthcare providers whose endurance and capability to do compression is weak.
—Guest reygen_14

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