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2010 AHA Guidelines

A Change from A-B-C to C-A-B

Rapid recognize

Safe area, firm surface Shake shoulder & shout Activate emergency respons

Unresponsive Not breathing or only gasping

Unresponsive Not breathing or only gasping Pulse check < 10 seconds

Early CPR Push hard & fast Complete recoil High quality (100x/m; depth 5 cm)

Breathing Head tilt - chin lift Jaw thrust without head extension

Mouth to mouth (regular breathing; over 1 second; chest rise)

≥ 2 rescuer

Switch position every 2 minute Interuption < 5 second

Re-evaluaate every 2 minute

Advance airway Intubation, stop compression- <10

second Breath 8-10x/min Compression 100x/min

Choking Back blow (infant) Cough Heimlich maneuver (child) Chest thrust

Recovery Position

Unresponsive, normal breathing, effective circullation

Airway, prevent obstruction

Indication of Intubation Inability to ventilate with bag mask: ventilator, obstruction, anesthesia

Absent of reflex protective airway: Unconscious, aspiration, suction

Preparation Scope Tube Airway Tape Introducer Connector Suction

Pediatric & Infant

• 1 rescuer 30:2• ≥ 2 rescuer 15:2• Depth 1/3 AP ( child 5cm; infant 4cm)

Infant :Intermammari lineTwo fingerMouth to mouth & noseMouth to noseMouth to mouth

Child :Lower half sternumOne or two hand

Pulse check : brachial artery in infant; carotid or femoral in a child

Palpaple pulse ≥60 with inadequate breath rescue breath 12-20x/min (1breath every 3-5 second), reassess the pulse every 2 minute

Pulse<60 with pallor/cyanosischest compression

2 rescuer15:2