On Aug. 15, 2000, the American Heart Association released major revisions to recommendations for cardiopulmonary resuscitation (CPR) and the treatment of cardiovascular emergencies. These new guidelines for both lay rescuers and healthcare providers cover a variety of topics such as CPR and automated external defibrillators (AEDs).

The changes were agreed upon by an international panel of experts following a process of scientific evidence evaluation and debate. These experts have agreed and recognized that a pulse check on an unconscious victim is often unreliable when performed by untrained laypersons. The recommendation was therefore made that no pulse check be done before bystanders begin administering chest compressions to an unconscious person.

Dr. Vinay Nadkarni, chairman-elect of the association's ECC committee 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.

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

If you have been previously trained in CPR, you will need to be re-trained when your current certification expires. The new CPR and advanced training materials will be available for widespread use by summer 2001.

Additional changes in the guidelines include increased access to automatic external defibrillator devices. To learn more about this, visit http://www.americanheart.org/.

Other recommendations include no longer checking for foreign bodies in the mouths of unconscious choking victims. Instead, the new guidelines suggest that one should begin chest compressions to dislodge the obstruction. It is believed that the chest compressions will generate enough negative pressure, just as would abdominal thrusts (Heimlich maneuver).

It is recognized that one could greatly decrease the amount of cardiac damage by beginning lifesaving CPR techniques within moments of the victim's collapse. The new guidelines hope to achieve that goal.