What to Expect from the Upcoming AHA CPR Guidelines in 2019?

New AHA CPR guidelines will be effective January 31, 2019. This update requires the use of an instrumented directive feedback device or manikin in All AHA courses that teach the skills of adult CPR. Incorporating these specific and targeted feedback devices are critical to students understanding and delivering high-quality CPR when faced with a cardiac emergency. This training will improve the quality and consistency of CPR training, and increase its effectiveness and success in its outcome. The evidence-based requirement impacts the association's Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), ACLS for Experienced Providers and Heartsaver adult CPR training courses in the United States and Internationally. There are two established standards for the device meeting requirement. Minimum Standard Instrumented, audio and or visual feedback on rate and depth of compression Optimum Standard Meets minimum standard and also includes auditory and or visual feedback on recoil and didactic(s) for proper hand placement. These audio-visual and corrective evaluation and instructions are done in real time. Manufacturers offer a variation of directive feedback devices as listed below.

  1. Device that can be added to and use with existing manikins
  2. Device built into manikins
  3. Device that can be used as a monitor or defibrillator with manikins or;
  4. A high-fidelity manikin (or computer-aided)

Examples of Devices and How they Operate The Practi-CRM is a directive feedback device that can be used with any training manikin. This flexible wrist band fits any size wrist and is worn on the wrist of the top hand when practicing CPR. It measures the rate of chest compressions being performed on a manikin. Effective chest compression rates are 100-120cpm. A red light will illuminate on the device when compression rates are BELOW 100cpm or ABOVE 120cpm. A green light will illuminate when compression rates are BETWEEN 100cpm - 120cpm. This will help students to self-correct or validate their skill performance immediately during training. The Brayden CPR Manikin with its built in device displays a red light that indicates a visual flow of blood from the heart to the brain during CPR training. Chest Compression red light illuminates within the chest cavity of the manikin indicating that the volume of blood being circulated is with effective depth of compression if met over 5cm. Blood Circulation red light illuminates within the carotid of the manikin indicating that the flow of blood from the heart to the brain is effective if the rate of compressions are over 100cpm. CPR Quality red light illuminates within the forehead of the manikin indicating that the blood is reaching the brain if depth and speed of compressions are correct. New CPR MANIKINS are in the making that can mimic movements and sounds associated with breathing, give real time vitals for a variety of situations, and record feedback if the responder (trainee)forget a step such as checking for a pulse. The new manikins are made so a LIVE AED can be used on it, something that hasn't been possible in the past! Training Centers and Instructors are advised to contact the device manufacturer directly regarding equipment capability. The goal of the AHA is to continually improve the quality of care during the resuscitation process by ensuring that their courses provide the correctly performed skills that give health care providers and others who are trained in CPR the assurance with helping to double survival rates from cardiac arrest by 2020. The AHA will eventually require the use of feedback devices for child and infant CPR courses as more devices become available.

Denise Y. Dawkins

Denise is a registered nurse having 18 years of vast experience in multiple specialties of adult health nursing. Owner of Dawkins InHouse CPR & Professional Services, Denise is chasing a global dream and joining forces with others who are passionate about saving lives by raising the awareness of sudden cardiac arrest through educating, empowering, and inspiring others one compression at a time.

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New AHA CPR guidelines will be effective January 31, 2019. This update requires the use of an instrumented directive feedback device or manikin in All AHA courses that teach the skills of adult CPR. Incorporating these specific and targeted feedback devices are critical to students understanding and delivering high-quality CPR when faced with a cardiac emergency. This training will improve the quality and consistency of CPR training, and increase its effectiveness and success in its outcome. The evidence-based requirement impacts the association's Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), ACLS for Experienced Providers and Heartsaver adult CPR training courses in the United States and Internationally. There are two established standards for the device meeting requirement. Minimum Standard Instrumented, audio and or visual feedback on rate and depth of compression Optimum Standard Meets minimum standard and also includes auditory and or visual feedback on recoil and didactic(s) for proper hand placement. These audio-visual and corrective evaluation and instructions are done in real time. Manufacturers offer a variation of directive feedback devices as listed below.

  1. Device that can be added to and use with existing manikins
  2. Device built into manikins
  3. Device that can be used as a monitor or defibrillator with manikins or;
  4. A high-fidelity manikin (or computer-aided)

Examples of Devices and How they Operate The Practi-CRM is a directive feedback device that can be used with any training manikin. This flexible wrist band fits any size wrist and is worn on the wrist of the top hand when practicing CPR. It measures the rate of chest compressions being performed on a manikin. Effective chest compression rates are 100-120cpm. A red light will illuminate on the device when compression rates are BELOW 100cpm or ABOVE 120cpm. A green light will illuminate when compression rates are BETWEEN 100cpm - 120cpm. This will help students to self-correct or validate their skill performance immediately during training. The Brayden CPR Manikin with its built in device displays a red light that indicates a visual flow of blood from the heart to the brain during CPR training. Chest Compression red light illuminates within the chest cavity of the manikin indicating that the volume of blood being circulated is with effective depth of compression if met over 5cm. Blood Circulation red light illuminates within the carotid of the manikin indicating that the flow of blood from the heart to the brain is effective if the rate of compressions are over 100cpm. CPR Quality red light illuminates within the forehead of the manikin indicating that the blood is reaching the brain if depth and speed of compressions are correct. New CPR MANIKINS are in the making that can mimic movements and sounds associated with breathing, give real time vitals for a variety of situations, and record feedback if the responder (trainee)forget a step such as checking for a pulse. The new manikins are made so a LIVE AED can be used on it, something that hasn't been possible in the past! Training Centers and Instructors are advised to contact the device manufacturer directly regarding equipment capability. The goal of the AHA is to continually improve the quality of care during the resuscitation process by ensuring that their courses provide the correctly performed skills that give health care providers and others who are trained in CPR the assurance with helping to double survival rates from cardiac arrest by 2020. The AHA will eventually require the use of feedback devices for child and infant CPR courses as more devices become available.

Vlad Magdalin

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