American Heart Association announces updated CPR guidelines that emphasize recovery

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The American Heart Association on Wednesday announced its new guidelines for cardiopulmonary resuscitation (CPR), with the recovery period following cardiac arrest ‒ when the heart abruptly stops beating ‒ now considered an important element of survival. 

The guidelines were updated, in part, to “address health disparities and the management of opioid-related emergencies,” the association said in a news release.

They were last updated in 2015.

The association said the new recommendations add a sixth element to the so-called “Chain of Survival,” defined as a “widely adopted series of critical actions that work to maximize the chance of someone surviving cardiac arrest.” 

In the U.S., cardiac arrest results in death 90% of the time when it occurs outside of a hospital setting, per the AHA. (iStock)

“The new, sixth link in the cardiac arrest chain of survival addresses recovery. It highlights the need for treatment, surveillance and rehabilitation for cardiac arrest survivors and their caregivers,” the AHA said. 

The recovery phase includes assessment for anxiety, depression, post-traumatic stress and fatigue for cardiac arrest survivors and their caregivers, as well as “rehabilitation assessment and treatment for physical, neurologic, cardiopulmonary and cognitive impairments before discharge from the hospital,” per the AHA. Additionally, the recovery phase includes “comprehensive, multidisciplinary discharge planning for cardiac arrest survivors and their caregivers, including medical and rehabilitative treatment recommendations and return to activity/work expectations.” 

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The new guidelines also encourage more bystanders to perform CPR in an emergency situation, as the AHA estimates that “less than 40% of non-hospitalized adults experiencing cardiac arrest receive layperson-initiated CPR before the arrival of emergency medical service.” (In the U.S., cardiac arrest results in death 90% of the time when it occurs outside of a hospital setting, the AHA noted.) 

The AHA also announced new information on pediatric CPR, now recommending “one breathe every 2-3 seconds or 20-30 breaths per minute." 

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Prior recommendations were based upon information extrapolated from adult data, the AHA said. 

Other updates include new recommendations on resuscitation during pregnancy, while two new opioid-associated emergency algorithms have been created to address “the increase in respiratory and cardiac arrests due to opioid overdoses,” per the AHA. 

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“The 2020 Guidelines represent a synthesis of important science that guides how resuscitation is provided for critically ill patients,” said Dr. Raina Merchant, chair of the American Heart Association Emergency Cardiovascular Care Committee and associate professor of emergency medicine at the University of Pennsylvania, in a statement. “As the science evolves over time, it’s important that we review it and make recommendations about how providers can deliver high-quality care that reflects the most updated and state-of-the-art information.”

You can read more about the new guidelines here.