2015 AHA ECC Guidelines

CPR compressions 5The new 2015 American Heart Association (AHA) Guidelines for CPR & ECC were released on 10/15/2015. A summary of the these changes are below along with links at the bottom of the page.


Category/Topic Lay Responder Recommendations Pro Responders/BLS Recommendations

General CPR
AED and CPR Use AED right away if available. If AED arrives while doing CPR, maintain CPR until “analyzing” prompt. Resume CPR immediately after shock or “no shock” prompt.
Ages for CPR Adult: post-puberty; Child: 1 yr to puberty (about 11 yrs old); Infant: 1 mo to 1 yr; Neonate: birth to 1 mo
C-A-B vs. A-B-C Use C-A-B for all victims and all types of arrest Use C-A-B for all victims except drowning victims who get A-B-C
Cellular Phone Added to steps for calling 911 or local emergency number so a lone rescuer can dial, put the phone on speaker, and continue care
Compression Fraction A compression fraction of at least 60% is recommended. To determine compression fraction (CF): CF=TC/TT, where TC is Time Giving Compressions and TT is Total Time.
Compression Rate 100–120 compressions per minute (30 compressions in 15–18 sec)
High-Quality CPR Continued emphasis on (1) pushing hard to achieve adequate depth, (2) pushing fast-100 to 120 cpm, (3) allowing full chest recoil between compressions, (4) minimizing interruptions in CPR-high compression fraction, and (5) ensuring adequate but not excessive breaths (1-sec breaths that make the chest rise)

Adult CPR
Compression Depth At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
Compression/Ventilation Ratio 30:2 (1-rescuer CPR only) 30:2 (1- and 2-rescuer CPR)
Hand/Arm Placement Heel of one hand on lower half of breastbone; heel of other hand on top and parallel; interlace fingers and lift so only the heel of the hand touches the chest; shoulders over chest; arms locked
Two-Rescuer CPR Rotation N/A Change every 2 min (5 cycles)

Pediatric CPR
Compression-Only CPR Do not use for child/infant patients; children and infants are more likely to suffer asphyxial arrest
Compression/Ventilation Ratio 30:2 (1 rescuer CPR only) 30:2 (1-rescuer CPR);
15:2 (2-rescuer CPR)
Finger/Hand Placement Child: Same as adult except one hand can be used as an option for small patients;
Infant: two fingers in center of chest just below intermammary line
Low Pulse N/A Give CPR is pulse is < 60 bpm and there are signs of poor circulation (e.g., pallor, cyanosis, etc.)

First Aid
Anaphylaxis Care Give a second dose of epinephrine after 10–15 min if the first dose has no effect
Aspirin for Chest Pain First aid provider may encourage a person with chest pain to take aspirin if the signs and symptoms suggest that the person is having a heart attack and the person has no contraindication to aspirin, such as allergy or recent bleeding. The suggested dose of aspirin is 1 adult 325-mg tablet or 2 to 4 low-dose aspirins (81 mg each), chewed and swallowed.
Avulsed Tooth Store avulsed tooth in one of these solutions for 30 – 120 min of viability (in order of preference): Hank’s Balanced Salt Solution, propolis, egg white, coconut water, Ricetral, or whole milk. If these are not available, use the patient’s saliva. Replantation should be attempted within 60 min.
Bleeding, Severe External Hemostatic agents and tourniquets recommended for severe bleeding not stopped by direct pressure and bandaging. No recommendation for using proximal pressure points, localized cold therapy, or elevation of an extremity.
Bruising (Minor Internal Bleeding) Use cold therapy with or without direct pressure
Cervical Collar Not recommended to be applied by first aid providers
Concussion Use of a simplified evaluation tool was considered or no recommendations were made; examples of scoring systems are AVPU, Glasgow Coma Scale, and Sport Concussion Assessment Tool (SPOT)
Dehydration, Exertion-Related 3% to 8% carbohydrate-electrolyte (CE) drinks are recommended. Alternates include water, coconut water, milk, tea, or tea-CE.
Eye Injuries, Chemical Large amounts of clean water recommended over saline or commercial eye irrigation solutions. The Poison Control Center should be consulted and all eye injuries of this kind should be evaluated by a physician.
Fractures Splint for movement only
Low-Blood-Sugar Care Glucose tablets recommended for symptomatic hypoglycemia. If glucose tablets are not available, various forms of dietary sugars can be considered. In test subjects, the change in glucose levels took between 10 to 15 minutes.
Recovery Position A lateral recumbent (side lying) position is now recommended over supine positioning for unconscious patients who are breathing. (In 2010, the recommendation was to leave the patient in supine position unless the patient vomited.) The HAINES technique was not considered superior to any other side-lying positions.
Shock Position Patients in shock should be placed in a supine position as opposed to an upright position
Sucking Chest Wounds Do not use occlusive dressing; it may trap air in chest cavity
Supplemental Oxygen Use Oxygen should be administered only by those trained in its use

Other Important 2015 ECC Links

The American Red Cross has recently published an informative website on 2015 ECC changes.

The American Health & Safety Institute has published 2015 ECC information and a timetable for implementing these changes.

The International Liaison Committee on Resuscitation (ILCOR) provides these changes to the entire world through various organizations including the American Heart Association and others equivalent to the American Heart Association in their country or region. These organizations include:

For updates to resuscitation in the area of veterinary medicine, check out the RECOVER website.