The American Heart Association updated 491 recommendations for adult, pediatric and neonatal life support to increase cardiac arrest survival rates, according to a summary of its 2020 guidelines released Oct. 21.
Five key updates:
- Cardiac arrest survivors should have a comprehensive recovery phase. This includes a formal assessment after the initial hospitalization to support patients' "physical, cognitive, and psychosocial needs," according to the summary. This support should continue as long as needed after the initial hospitalization.
- Lay rescuers, or bystanders, should initiate CPR early on. The AHA said the risk of harm from CPR is low, even if the patient is not in cardiac arrest.
- Pediatric resuscitation increased to one breath every two to three seconds. This provides 20-30 breaths per minute.
- Naloxone should be administered for cardiac arrest caused by an opioid overdose. CPR should also be given immediately.
- Fetal heart monitoring is not helpful during maternal cardiac arrest. Attempting to evaluate the fetal heart may distract from maternal resuscitation.
The addition of a recovery phase is one of the biggest changes to AHA guidelines, Raina Merchant, MD, chair of the AHA Emergency Cardiovascular Care Committee who helped write the guidelines and associate professor of emergency medicine at the University of Pennsylvania in Philadelphia, told American Heart Association News.
"It's a new focus on what we can do to support their physical, cognitive and psychosocial needs after they have a cardiac arrest and after they leave the hospital," Dr. Merchant said. "The latest research tells us that's really important."