New 2010 CPR Guidelines: American Heart Association and American Red Cross

In 2010 the American Heart Association (AHA) and the American Red Cross (ARC) adopted new CPR guidelines. This article examines the similarities and differences between both organizations’ CPR guidelines.
ADULT CPR

What follows is my paraphrasing of the AHA and ARC’s Adult CPR guidelines. They are meant as a point of comparison for this article, not to be taken as either organizations’ stated guidelines. Visit the AHA and ARC websites or buy their course manuals to compare their nomenclature and exact guidelines.

American Heart Association

1) Make sure the scene is safe before approaching the victim.
2) Check to see if the person responds by tapping the victim and shouting, “Are you OK?
3) If the person doesn’t respond, get help. Have you and someone else call 911 and get an AED (automated exte
al defibrillator) if available.
4) Check for breathing. The breathing should be normal, not gasping. If the person is not breathing or only gasping, they need CPR.
5) Begin CPR with 30 chest compressions. Push down at least 2 inches. The rate of compressions is at least 100 compressions a minute. After each compression let the chest come back up to its normal position.
6) Open the airway with a head tilt-chin lift and give 2 breaths.
7) Continue giving 30 compression and 2 breaths until the person starts to respond, you are too exhausted to continue, the scene becomes unsafe, an AED arrives or EMS (Emergency Medical Services) arrives.

American Red Cross

1) Make sure the scene is safe before approaching the victim.
2) Check to see if the person responds by tapping the victim and shouting, “Are you OK?”
3) If the person doesn’t respond, get help. Have you and someone else call 911 and get an AED (automated exte
al defibrillator) if available.
4) Check for breathing by performing a head tilt-chin lift. Look, listen and feel for breathing for no more than 10 seconds. Occasional gasps are not breathing.
5) Quickly scan for severe bleeding.
6) Begin CPR with 30 chest compressions. Push down at least 2 inches for an adult. The rate of compressions is at least 100 compressions a minute. After each compression let the chest come back up to its normal position.
7) Open the airway with a head tilt-chin lift and give 2 breaths.
8) Continue giving 30 compression and 2 breaths until you find an obvious sign of life, you are too exhausted to continue, the scene becomes unsafe, an AED arrives or EMS (Emergency Medical Services) arrives.

Differences: The primary difference is how breathing is assessed. The AHA has eliminated, “look, listen and feel for breathing” from its guidelines. The responder checks for breathing, but how this is done is not specifically stated. The ARC still instructs, “look, listen and feel” for breathing.

The ARC continues to include the step of quickly scanning for severe bleeding after checking for breathing. The AHA does not include this step.
INFANTS AND CHILDREN

Rather than include a list of both organizations’ sequences for infant and child CPR, I’m only going to discuss the differences in their guidelines.

1) The AHA follows the CAB (compressions, airway, breathing) sequence for infants and children who don’t respond and aren’t breathing normally. CPR always begins with chest compressions no matter who the victim is and whether you witnessed their collapse or not.

The ARC takes a different approach if you did not witness the infant or child collapse: If there is no response and breathing is not normal, give 2 rescue breathes. Then scan for bleeding. If the victim still isn’t breathing normally, begi
CPR with the CAB sequence.

However, if you witnessed the child or infant collapse you would use the CAB sequence – the 2 initial rescue breaths are not given.

2) The AHA has also eliminated “look, listen, and feel” for breathing in the assessment for infants and children. The ARC still uses this approach as part of their guidelines for infants and children.