AHA CPR Guidelines – Latest Jan 2014

AHA official guidelines for CPR – Latest as Jan 2014

It has been more than 3 years since the last official CPR guidelines were updated in 2010. The most important change in the latest guideline was moving from ABC (airway – breathing – chest) to CAB (chest, airway and breathing sequence)

Fast forward to 2014, we have listed here the most updated and latest guidelines till date. Please let us know the comments section, if you want to add or suggest an edit. We look forward to your opinions.

The American Heart Association is one of the organizations to mandate CPR and first aid rules. It has recently announced that giving rapid chest compression for CPR is recommended and not mouth-to-mouth resuscitation. Studies have also shown that more than 22% lives are saved by hands-only – chest compression – CPR than other methods.

AHA or American Heart Association updates CPR guidelines, according to advancements and findings made in the world of healthcare, science, technology and also the ever changing human anatomy. The recent update in the CPR guidelines as per AHA was made in 2010 for new AED CPR rules.

Current AHA official guidelines for CPR

The new CPR guidelines of AHA emphasize on compressions – According to the guidelines, a rescuer needs to press not only hard but fast. This is irrespective, whether the rescuer is an expert or a regular bystander.

CPR – in a simplified format lays focus on providing chest compressions – Chest compressions help in maintaining blood flow and also oxygen in the same. As a result, blood flow is boosted and directed properly to the brain and heart of the concerning patient.

The ABC sequence has changed to CAB sequence – According to old guidelines, the ABC sequence of emergency cardiac care was accepted – Airway – Breathing – Compressions. In the updated guidelines, it has transformed to CAB sequencing – Compressions – Airway – Breathing. Rescuers should conduct a brief assessment and determine whether the victim is responding or not. Along with this, he/she should check for normal breathing for less than 10 seconds’ time-frame. Professionals also check for obvious pulse and if it is absent for less than 10 seconds, then 30 Cs or compressions should be provided immediately, followed by opening the airway by tilting head and lifting the victim’s chin and finally providing two rescue ventilations or B of C-A-B. The entire process must be continued in the ratio 30:2 until the arrival of EMS or AED.

Starting with the step of giving chest compressions in a way, makes it easier to remember and help in instant response – time is critical in emergencies calling for the administration of CPR. The old approach, many experts believe, caused delays in the process of giving chest compressions. And chest compressions are crucial for maintaining proper circulation of blood in a victim.

Following the new CPR guidelines from the American Heart Association

  • First call 911. If not, others to call.
  • Make the victim respond. If he/she does not respond, roll him/her on his/her back.
  • Now in the 3rd step, start giving chest compressions by placing your hand’s heel part on the center of the chest of the victim, with the other hand placed on top of it, with interlaced fingers.
  • Now press down and compress the chest approximately 2 inches in case of children and adults, but for infants, it should be 1.5 inches.
  • Open airway by tilting the victim’s head and lifting chin. This can be done, only if you have proper knowledge and training in CPR.
  • Pinch the victim’s nose and breathe normally into his/her mouth by covering his/her mouth first. This helps in creating an airtight seal. Give rescue breaths for 2 seconds and determine whether the victim’s chest rises or not.
  • Carry on giving chest compressions and breaths in the ratio – 30:2 for 100 compressions per minute, till the time any medical assistance arrives.

The new CPR guidelines of AHA encourage more and more bystanders to perform CPR and handle emergencies. Giving mouth to mouth resuscitation is not easy for an untrained bystander. However, giving chest compressions is not at all difficult. In fact, if someone performs perfect chest compressions, he/she can save a life in the process.

Cricoid pressure used during ventilation is no more part of the changed guidelines. This particular step was present earlier, used on a deeply unconscious patient. It was changes according to studies that showed risks of the method – cricoid pressure might obstruct ventilation. Furthermore, it is also not easy for professional rescuers to use cricoid pressure. Therefore, the maneuver was made to discontinue as per new CPR guidelines of American Heart Association.

CPR guidelines experience regular changes and updates, whether in case of the American Heart Association or American Red Cross. It will only be effective, if you get acquainted with the changes. At times, it makes a lot sense that CPR certification comes with a 2 years’ duration, after which, you will require renewing your CPR certification. In order to renew your CPR certification, you will have to take up CPR training course again and sit for an exam. This way, you will get to learn the new methods and avail updated procedures and information relevant to CPR and first aid.

Cardiac arrest, near-drowning, electrocution, choking etc. are emergencies that need an instant response. With prior knowledge and training in first aid and CPR, you can ensure the safety, as well as, as life of a person going through such medical emergencies. Ill-information or lack of information might make the situation worse and cause a life. Therefore, it should become a mandatory obligation for everyone to learn the basics of CPR, first aid and also keep each other updated about the changes made in their guidelines by major organizations. At the end of the day, we need to keep in mind the facts – 80% medical emergencies occur in places other than hospitals and medical facilities and people handling these crises are regular people – bystanders!

What do you think about this post? Share your thoughts in our comments section


  1. Hi, I am working as BLS-ASCLS instuctor in Sagar hospitals, Bangalore since 2yrs. Since all the nursing staff cannot take ACLS course instantly due to staffing problem, I am giving orientation of ACLS & PALS when the staff come for BLS in order to get used to crash trolley items. Periodically I am checking for updates and I found the above mentioned information is also useful for the staff to learn well. Thanks for this information.
    HVSM, AHA-BLS & ACLS Instructor

  2. azadehjou abbas says:

    not shocble cardiac arrest and treatment

  3. I was wondering when the rescue breaths are going to be shortened. Useful info and very applicable and practical as well.

  4. Hi there. I’ve been oriented then from my nursing school that the rescuer must first ask the victim if she’s OK before asking somebody to call 911. So now calling 911 must come first before making the victim respond. Thanks.

  5. Lawrence Lee says:

    Is that any tutorial video for it? :)

  6. Rajasekharan Nair,
    Public Safty Instructor,(FAST)
    Indian Institute of Emergency Medical Service.
    :Hands on CPR will very effective for General People :

  7. Indian Institute of Emergrency Medical Service Conducting First Aid and Safty training programme (First Responder Course) at all states of India for Govt. Organisations, Schools, Colleges, etc since 2004.

  8. I have been told by my instructor the compression to breath rate is now 30 to 1 however, everything in every book show this as 30 to 2. Which is correct please?

    • kim fawkes says:

      Hi Ellen
      The Australian Resuscitation Council still recommends 30:2. I don’t know where your instructor (what are their qualifications and experience?) got 30:1 from, though they may be thinking that breathing has little value in resuscitation because the average person still has oxygen in their body from normal ventilation. I can see a time in the future where breaths are discarded completely in favour of compressions only for the lay person though the emergency services may still give supplementary oxygen via a mask, cheers Kim

    • 30:2 is correct.

  9. kim fawkes says:

    G’day I’m a first aid trainer and I am still being told to teach my students DRSABCD. But you indicate we should do DRSCABD. Is that right? I don’t know if the Australian Resuscitation Council will be passing this onto us but in any event, it seems that I should now put compressions ahead of checking the airway and doing two breaths. I have been advising my students of this change in CPR practice and they also query why they should have to do two breaths when it has been shown that breathing into an unconscious person’s lungs don’t really do that much, that the fact the person was breathing minutes ago means they should have enough oxygen in their body. Cheers, Kim

  10. Hari krishna says:

    Rescue breaths are given 30:2.
    1) Are these breaths given only for 2 seconds duration each or more. If so whats the duration.
    2) What is the interval or gap between 2 breaths.
    3) Does the duration of each breath varies in children and adults. If so, please mention.

    • kim fawkes says:

      G’day, there is no real duration of breaths. As soon as you finish one, you give the other, making sure you look and feel for the rise and fall of the chest before repeating this action. Breathing into a child or adult’s mouth is pretty much the same (pinch their nostrils, seal their mouth with yours or use a face shield mask) as you will need to give two quick breaths whereas with an infant you only give two puffs so as to not hyper-inflate their lungs. It is interesting that the AHA recommends chest compressions ahead of breaths as the whole process of checking the airway and breathing wastes valuable time that could be better spent on compressing the heart even though this method only increases cardiac output by about a third compared with normal heart function.

      I hope this answers your question.

  11. Really Informative for the update. Thxs a lot

    • kim fawkes says:

      Hi, I know that pushing down on the chest is how one does compressions to simulate the heart’s contraction and relaxation phase so when you say Airway – Breathing – Chest, don’t you mean Airway – Breathing – Compressions? Compressions are more important than airway and breathing if the casualty is in life thtreat, i.e. cardiac arrest, but if they are unconscious from an epileptic seizure for example and are breathing and have a strong pulse then there would be no need for compressions so airway and breathing would be more applicable here. Cheers Kim

      n’t in life threat and had Cheers Kim

  12. wilbernetta says:


    • kim fawkes says:

      Hello My understanding is based on the current Australian Resuscitation Guidelines. D – Danger, Response – do they respond? Are they conscious/unconscious? If unconscious or they require additional medical assistance, then S – Send for help, cheers Kim

  13. For training purposes always insist that the learner uses his or her own PVC mouth piece with a non return valve. What usually happens is that if a learner is suffering from a contagious disease such as TB he or she may pass the bacterium through the mouth piece into the dummy and the next person can do the same if they are a sufferer until there is a build up of TB sputum in the lungs of the dummy . When chest compressions are performed the contaminated sputum is ejected back to the mouth area and there is a danger of the learner who is not a sufferer of TB or if he or she is not using a non return valve mouth piece can be infected realising that TB is spread by the contaminated sputum from one to another. Take care and be safe.

  14. Hellow , Indian Institute of Emergency Medical Services conducting BLS, ACLS, PALS, ATCN, AREMT, BDLS, ADLS Courses since 2005. We also conducting First Responder level courses for police Force, Fireforce, Motor Vehicle Department, Schools, Colleges, Residential Associations, Charitable Trusts etc.

  15. My friend died two days ago after he collapsed at our school. I was in the building, but no one made me aware this was happening at the time. No one performed CPR. I guess no one knew. I was certified long time ago, but let it expire. I would have done something. At least the compressions. Maybe it was his time to die, but I would have tried! My goal is to get people in our school building to get certified in CPR. No shift in our school should be without at least one person knowing CPR. I am devastated that I was not given a chance to save my friend when compressions alone might have saved him.

    • Miki, I am so sorry for your loss. Yes i think trained and certified people can really help save lives. You should try to educate more about the importance of getting CPR training

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