2020 CPR Guidelines Science & Education Updates

The paragraph introduces Nancy Brown, the chief executive officer of the American Heart Association, who welcomes the audience to the launch of the new 2020 CPR & ECC CPR guidelines. It emphasizes the AHA's role as the first and only United States training organization directly involved in creating resuscitation science and education. The script highlights the AHA's response to the pandemic, including providing training for health care providers treating COVID-19 patients and launching an online adaptive learning platform. The paragraph concludes with Dr. Peter Morally's introduction, who will discuss the development of the AHA guidelines for CPR & ECC.

This paragraph discusses the American Heart Association's unmatched leadership in resuscitation research, science, and education. It highlights the bold advocacy efforts that continue to advance quality care. The paragraph mentions the involvement of many scientific experts discussing the updated guidelines, which address health disparities, opioid-related emergencies, and recovery after cardiac arrest. The focus is on being bold and demanding change to swap challenges for opportunities, aiming for a world of longer, healthier lives. The paragraph concludes with the introduction of Dr. Peter Morally to kick off the event.

Dr. Peter Morally provides an overview of how the official AHA guidelines for CPR & ECC are developed. The process involves formulating a topic into an answerable question, conducting a detailed review of scientific evidence, and creating a reference list. The information from these studies is then analyzed and combined using a standardized approach. The paragraph also discusses the International Liaison Committee on Resuscitation (ILCOR), its mission, and its role in creating consensus on science statements and treatment recommendations. The process includes various types of reviews, such as systematic, scoping, and evidence updates, which form the scientific foundation for resuscitation guidelines.

The paragraph focuses on the updates in the 2020 adult AHA guidelines, aimed at providing a comprehensive look at cardiac arrest care. It covers the full spectrum of the chain of survival, including bystander interventions, pre-hospital management, and cardiac arrest care in both the emergency department and in-hospital settings. The guidelines present 250 new and updated recommendations, reaffirming the importance of high-quality CPR and early defibrillation for shockable rhythms. The paragraph also discusses the importance of epinephrine, especially for non-shockable rhythms, and presents new algorithms for managing special circumstances like cardiac arrest in pregnancy and opioid-associated cardiac arrest.

This paragraph addresses the management of special circumstances in resuscitation, such as cardiac arrest in pregnancy and opioid-associated cardiac arrest. It highlights the importance of optimizing outcomes during arrest, including uterine displacement and delivery for pregnant patients. The guidelines feature an in-depth evaluation of the literature on opioid-associated cardiac arrest and present new algorithms based on a new scientific statement. The paragraph also emphasizes the importance of post-cardiac arrest care, including temperature management, EEG management, and neuroprognostication, with a focus on timing and a multi-modal approach.

The paragraph discusses updates in the AHA 2020 pediatric basic and life-support guidelines, focusing on CPR, airway management, and post-arrest care. It mentions no specific changes to chest compression recommendations but continues to emphasize the critical importance of high-quality CPR. The paragraph introduces a time frame for administering the initial dose of epinephrine within five minutes from the start of chest compressions. It also addresses new recommendations for children with respiratory or cardiac arrest from opioid overdose, extrapolated from adult guidelines. The paragraph highlights changes in ventilation rates for infants and children, with new data suggesting higher ventilation rates are associated with improved outcomes.

This paragraph discusses the importance of recognizing recovery as a key aspect of the chain of survival. It emphasizes the need for organized planning to optimize a patient's outcome as they transition home. The guidelines leverage a new scientific statement on survivorship and highlight the process of recovery. The paragraph also introduces a post-cardiac arrest care checklist to provide clinicians with an accessible approach following cardiac arrest. It updates the pediatric chain of survival, adding a sixth link focusing on short- and long-term treatment, evaluation, and support for survivors and their families. The paragraph concludes with recommendations for evaluating pediatric cardiac arrest survivors for rehabilitation services and ongoing neurologic evaluation.

The paragraph presents the work of the AHA writing group for the neonatal guidelines. It mentions that the 2020 neonatal guidelines follow the steps of the algorithm, which is unchanged from 2015, addressing the needs of every newborn and those at risk for or with respiratory compromise. The paragraph emphasizes the importance of anticipating the need for resuscitation and preparing appropriately. It reaffirms that most newborn infants do not require immediate cord clamping or resuscitation after birth, and healthy newborns can be monitored while enjoying skin-to-skin contact with their mothers. The paragraph also discusses the importance of effective positive pressure ventilation and corrective steps in neonatal care.

This paragraph focuses on updates to resuscitation education, highlighting the importance of educational efficiency and evidence supporting various instructional design features. It discusses deliberate practice, booster training, and space learning approaches, emphasizing the benefits of these methods for enhancing resuscitation skill acquisition. The paragraph also covers the use of CPR feedback devices, team work training, and the importance of using high-fidelity mannequins and in situ training for improving training effectiveness. It concludes with recommendations on gameified learning and virtual reality, suggesting their potential for enhancing learner outcomes in basic and advanced life-support training.

The paragraph discusses the importance of self-directed CPR training for layperson learners, recognizing its ease of use and cost-effectiveness. It recommends the implementation of multiple strategies to increase awareness of cardiac arrest and delivery of bystander CPR, including mass media campaigns and self-directed learning. The paragraph also emphasizes the importance of public access to defibrillation programs, particularly in communities at higher risk for out-of-hospital cardiac arrest. It highlights the effectiveness of dispatcher-assisted CPR instructions and the potential of mobile app technology to alert lay rescuers to the presence of a cardiac arrest victim and the location of the closest AED.

The paragraph discusses the systems of care working group's focus on the most efficient way to deliver beneficial interventions to as many patients as possible. It covers the importance of the new recovery link in the chain of survival and various ways to improve layperson CPR or lay rescuer CPR rates. The paragraph highlights the significance of early warning symptoms and the use of data to improve outcomes, both at the individual resuscitation event level and through participation in cardiac arrest registries. It also reviews the evidence for cognitive aids in resuscitation for both lay rescuers and health care providers, as well as the increasing recognition of debriefing as an important component of improving team performance.