New Requirements for American Heart Association Adult CPR Courses

New Requirements for American Heart Association Adult CPR Courses

Real-time feedback devices improve quality and provide consistency in CPR training

DALLAS, TX--The American Heart Association – the world’s leading voluntary health organization devoted to fighting cardiovascular disease – will now require the use of an instrumented directive feedback device in all courses that teach adult CPR skills, effective January 31, 2019. The devices provide, real-time, audiovisual and corrective evaluation and instruction on chest compression rate, depth, chest recoil and proper hand placement during CPR training.

The Association’s evidence-based 2015 Guidelines Update for CPR and ECC highlights the emerging benefits of feedback devices. Studies reveal that this technology, which can be integrated into or serve as an accessory to a manikin, helps students master these critical CPR skills and reduces the time between training and demonstration of competence in a training environment.

This new requirement impacts the Association’s Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), ACLS for Experienced Providers and Heartsaver® adult CPR training courses taught in the United States and internationally.

“The American Heart Association trains more than 22 million people in CPR annually through its course offerings. Requiring a feedback device further solidifies its global leadership position in resuscitation science and CPR education training,” said Mary Elizabeth Mancini, Ph.D., MSN, American Heart Association volunteer and professor, senior associate dean for education innovation at The University of Texas at Arlington College of Nursing and Health Information. “Specific and targeted feedback is critical to students understanding and delivering high-quality CPR when faced with a cardiac emergency. Incorporating feedback devices into adult CPR courses improves the quality and consistency of CPR training, which increases the chance of a successful outcome when CPR is performed.”

When CPR is taught and performed according to the American Heart Association’s CPR and ECC Guidelines, chest compressions are delivered at a rate of 100 to 120 compressions per minute and a depth of at least two inches. To comply with the new course requirement, feedback devices must, at a minimum, measure and provide real-time audio and/or visual feedback on compression rate and depth, allowing students to self-correct or validate their skill performance immediately during training.

Manufacturers offer a variety of instrumented directive feedback devices to address the chest compression rate and depth requirement, as well as provide feedback on hand placement. Training Centers and Instructors should contact device manufacturers directly regarding equipment capability. The Association cannot review or recommend specific equipment and is communicating this upcoming training requirement more than 16 months prior to January 2019, providing ample time to its Training Network to research, identify and incorporate device solutions into the Association’s courses.

“Integrating science and technology into CPR courses significantly enhances and augments the CPR training experience,” said Mancini. “The American Heart Association’s adult CPR courses are just the beginning. As more devices become available for child and infant CPR, the American Heart Association will require the use of feedback devices in courses that teach the skills of child and infant CPR.”

“CPR saves lives and ensuring our courses provide the necessary, correctly performed skills gives healthcare providers and others trained in CPR confidence and empowers them to help in doubling survival rates from cardiac arrest by 2020,” she said.

Each year, more than 350,000 cardiac arrests occur outside the hospital and over 200,000 occur in a hospital setting. Only 46 percent of people who suffer an out-of-hospital cardiac arrest receive bystander CPR before professional help arrives. CPR, if performed immediately and correctly, can double or triple a victim’s chance of survival.

Additional scientific information, evidence and research on feedback devices and CPR training can be found in “Part 14: Education, CPR Feedback/Prompt Devices in Training” of the 2015 American Heart Association Guidelines Update for CPR and ECC.

SOURCE: American Heart Association

Bob Trenkamp's picture
Bob Trenkamp wrote 14 weeks 3 hours ago

CPR saves lives, if you can do it.

One assumption many people make is that, if they learn CPR, they will be able to perform it when the opportunity presents itself.

Sorry. That's not the whole story.

The amount of force required to compress a human chest to a two-inch depth depends upon the stiffness of the victim's chest (i.e., how many pounds of force does it take to get to two inches). A rescuer's ability to compress that chest depends upon the rescuer's weight and weight distribution, and the method of compression used (hand or heel). Those who were taught to crunch their abdominal muscles during the down-stroke can generate some additional force, but I've never seen anybody be able to do that for more than two minutes.

The average adult chest stiffness requires 130 pounds to get a two-inch compression. The average rescuer has to weigh somewhere about 25% more than the victim's chest stiffness, if performing compression manually - a bit less if performing compression with the heel of the foot - to get a two-inch depth.

About 70% of all cardiac arrests occur in a private residence. Two-thirds of arrest victims are male. A study by Trenkamp and Perez presented at the AHA Q-COR conference in Alexandria, VA in the spring of 2017 suggested that the percentage of all homes with two adults where each adult could perform a single two-inch compression on the other was zero percent. The cohort was assembled from zip code 31411. Households responding with data for only one person were excluded. The age distribution was significantly biased toward people in their 70's, probably due to (a) where the sample was recruited, and (b) people who took the time to fill out the response and return it.

By this point in the discussion, someone has usually said "But ANY CPR is better than no CPR!" Let me offer two other considerations: (1) with sufficiently shallower than guideline compression depth, there is an enhanced chance that the after the heart is re-started, the victim will not be able to handle the activities of daily living without assistance. (2) Dr. Vadebancoeur et al in Resuscitation 84 (2014) 182-188 reported on chest compression depth and survival in 593 out-of-hospital cardiac arrests. The survivors received 2.11 inch depth compression, on the average. The non-survivors received 1.92 inch depth compressions.

On a personal note, I know my chest requires 141 pounds of force to compress to a two-inch depth, because I measured it. My wife weighs 114 pounds. We have an AED and take it with us when we travel.

Bob Trenkamp, President
slicc.org

Bob Trenkamp, President
Saving Lives In Chatham County
www.slicc.org

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