2015 Updated AHA BLS Guidelines

Chris de la Victoria, MSN, RN, CMSRN, CDP

* AHA BLS Instructor

* Affiliate of Life Savers, Inc.*** Guidelines for CPR and Emergency Cardiovascular Care

BLS 2015: Immediate Recognition and Activation of ERS

BLS 2015: Immediate Recognition and Activation of ERS2010: A very methodical process was emphasized

2015: A more simultaneous approach

• Check for responsiveness• Check for no breathing or no normal

breathing• Call for help• Check for pulse

• Call for nearby help after finding an unresponsive victim

• Assess breathing and pulse simultaneously.

• Fully activate emergency response system or call for backup.

Breathing and Pulse• 2015: Simultaneous breathing and pulse check in less than 10

seconds!

Emphasis on chest compressions• The foundation of high-quality CPR is effective chest compressions. • Healthcare providers should provide chest compressions and

ventilations. • Hands-only CPR is suitable for untrained rescuers because it is easier

for the emergency dispatchers to provide direction over the phone.

Shock vs. CPR2010 2015For an unwitnessed arrest, 1 and ½ to 3 minutes of CPR may be considered before attempted defibrillation

• For witnessed adult cardiac arrest when an AED is immediately available, use as soon as it is ready.

• For unwitnessed adult cardiac arrest, or when an AED is not immediately available, immediately start CPR while the AED is being retrieved and while it’s being applied to the victim. Then use as soon as it is ready.

• CPR should be provided while the AED pads are being applied and until the AED is ready to analyze the rhythm.

Chest Compression Rate2010 2015• Deliver chest compressions at a rate of

at least 100 per minute.• Deliver chest compressions at a rate of

100 to 120 per minute. • Result in better intra-arrest end-tidal

carbon dioxide and blood pressure. • ROSC and survival to discharge are

more favorably effective.• Adult sternum should be depressed at

least 2 inches (5cm).• During manual CPR, chest

compressions should be at least 2 inches (5cm), but no more than 2.4 inches (6cm) to reduce the risk of injury.

Ventilation rate during CPR with advanced airway2010 2015• Give 1 breath every 6 to 8

minutes with continuous chest compressions.

• Give 1 breath every 6 seconds with continuous chest compressions

Pediatric BLS

ERS• In a continuous effort to minimize delay, the encouragement of

simultaneous assessment of breathing and pulse. • Simultaneous assessment of breathing and pulse that mirrors adult

recommendations.

CPR Sequence: Infant• Left unchanged. • 1 rescuer: Begin with 30 compressions, followed by 2 breaths.• 2 rescuers: Begin with 15 compressions, followed by 2 breaths.• Rate for infants and children: 100 to 120 minutes.

Chest Compression Depth• Provide chest compressions at least one-third AP diameter of chest in

pediatric patients.

Age New Compression Depth

Infants Approximately 1.5 inches (4 cm)

Children About 2 inches (5cm)

At puberty Follow adult recommendations

Adults Compressions should be at least 2 inches (5cm), but no more than 2.4 inches (6cm)

All Done! Let’s Go!

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