For release: 10am ET August 15, 2000

Contact: Journal copies only: (214) 706-1173 For other information, call: Carole Bullock: (214) 706-1279, Karen Hunter: (214) 706-1330

The new guidelines were announced at a news conference today in Washington, D.C. and will be published in the August 22 issue of Circulation: Journal of the American Heart Association.

The International CPR and ECC Guidelines 2000 are designed for both lay rescuers and healthcare providers and include the most effective methods for treating cardiovascular emergencies such as sudden cardiac arrest, heart attack and stroke. They were developed by an international panel of experts following a process of scientific evidence evaluation, debate and consensus development.

"These are lifesaving measures and we wanted them to reflect the most up-to-date science," says Rose Marie Robertson, M.D., president of the American Heart Association and professor of medicine at Vanderbilt University Medical Center in Nashville.

"We recognize that it is very difficult for a layperson to assess whether a patient has a pulse within the first few seconds of a cardiovascular emergency," says Vinay Nadkarni, M.D., chairman-elect of the association’s ECC committee and director of pediatric intensive care at the A. I. duPont Hospital for Children in Wilmington, Del. He says research indicates that at least 35 percent of lay rescuers are wrong about whether or not a victim has a pulse. Therefore, the new guidelines recommend that the general public instead look for normal breathing, movement, response to stimulation and other signs of circulation when deciding whether to begin chest compressions.

The deletion of the pulse check from layperson CPR training has already been successfully implemented by the United Kingdom and European Resuscitation Councils, Nadkarni says.

However, the guidelines continue to recommend that trained healthcare professionals check for a pulse before doing chest compressions.

The changes in CPR guidelines mean that individuals who have previously been trained in CPR will need to be re-trained when their current certification expires. The new CPR and advanced training materials will be available for widespread use by next summer.

The updated guidelines place major emphasis on early defibrillation for ventricular fibrillation and AEDs as a tool to increase sudden cardiac arrest survival. AEDs are easy to use. Two electrodes are applied to the chest and the device automatically senses the heart rhythm and determines whether a lifesaving electric shock is necessary. The AED prompts the user to deliver a shock and all the bystander has to do is press the "shock" button. Prompt bystander CPR combined with early defibrillation have produced survival rates exceeding 50 percent in some early defibrillation programs.

The guidelines urge greater availability of AEDs - and people trained to use them - in fire trucks, ambulances, police cars, public buildings, sports arenas, theaters and airports. "If you walk through O’Hare Airport in Chicago, you are never more than a minute away from a defibrillator, and they are saving lives." says Robertson. "This means the general public has easy access to AEDs in the event an individual goes into sudden cardiac arrest at the airport and requires quick defibrillation.

"The changes in the CPR guidelines are aimed at simplifying training by focusing on the most effective aspects of resuscitation. The public can be assured that people trained using these guidelines are getting the most up-to-date science," says Robertson. "These updated guidelines will enable the trained rescuer to do a better job in assisting individuals experiencing a cardiovascular emergency."

Other new recommendations include:

· Streamlining/standardizing the ratio of chest compressions to breaths during adult CPR.

· Updated recommendations for emergency medical personnel such as medication treatment protocols for heart attacks, stroke and cardiac arrest in victims of all ages.

· Simplification of CPR instruction. For example, techniques to teach management of choking (airway obstruction) in an unconscious victim have been greatly simplified. "There is evidence that chest compression in CPR creates enough pressure in an unconscious patient to eject a foreign body from an airway," Nadkarni says. The use of abdominal thrusts (commonly known as the Heimlich maneuver) to clear an object from the airway of a conscious person will still be taught under the new guidelines.

Media Advisory: Dr. Robertson can be reached by e-mail at

The American Heart Association’s International Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Guidelines set a new global standard for the treatment of cardiovascular emergencies such as sudden cardiac arrest, heart attack and stroke. They are the first truly international guidelines, written after two years of rigorous scientific debate and evaluation by hundreds of the world’s top resuscitation research scientists. Experts from Australia, Europe, Canada, Japan, New Zealand, Latin America, Saudi Arabia, Southern Africa and Thailand contributed to the development process.

The CPR and ECC guidelines provide the most effective, science-based treatment recommendations to everyone from the lay public to healthcare providers to help them save more lives from cardiovascular emergencies. The guidelines’ recommendations are being incorporated into the American Heart Association’s CPR and advanced life-saving courses and are available for use by other organizations.

Important new recommendations were developed during the American Heart Association International Guidelines 2000 Conference in February, 2000 and during the post-conference review process. The Guidelines 2000 conference was the world’s first international conference assembled specifically to produce international resuscitation guidelines.

The guidelines confirm safety and effectiveness for many approaches, acknowledge the ineffectiveness of others and introduce new treatments that have survived intensive evidence-based evaluation. The 2000 guidelines provide the most effective and easy-to-learn resuscitation methods that current knowledge, research and experience can provide.

Modern CPR and ECC methods were introduced in the 1950’s and 60’s to save the lives of people who had stopped breathing and whose heart had stopped. First described in 1956, the ability of defibrillators to restart the heart was a dramatic medical achievement. Mouth-to-mouth breathing was shown to be effective in 1958 after researchers learned that throughout history, midwives used the technique to save the lives of newly born infants. In 1960, chest compressions were found to be effective for circulating blood when a victim’s heart had stopped.

CPR training has been recommended for healthcare professionals for more than 30 years and for the lay public for more than 25 years. The American Heart Association established guidelines for resuscitation and has continued to improve and update CPR and ECC guidelines using the latest science-based techniques. Previous American Heart Association guidelines were published in 1974, 1980, 1986 and 1992, and have been used as the basis of other major organizations’ CPR and advanced care training courses.