Approximately every five years the International Liaison Committee on Resuscitation (ILCOR), updates the guidelines for CPR and ECC (Emergency Cardiac Care).
The content contained herein is based on the most recent ILCOR publications on BLS. Recommendations for adult basic life support (BLS) from the 2020 Guidelines for CPR and ECC include the following:
- The importance of early initiation of CPR by lay rescuers has been re-emphasized. The risk of harm to the patient is low if the patient is not in cardiac arrest. Bystanders should not be afraid to start CPR even if they are not sure whether the victim is breathing or in Cardiac Arrest.
- A sixth link, Recovery, was added to the Chains of Survival for both Pediatric and Adults.
- Care of the patient after the return of spontaneous circulation (ROSC) requires close attention to oxygenation, blood pressure control, evaluation for percutaneous coronary intervention, targeted temperature management, and multimodal neuroprognostication.
- Because recovery from cardiac arrest continues long after the initial hospitalization, patients should have formal assessment and support for their physical, cognitive, and psychosocial needs.
- After a resuscitation, debriefing for lay rescuers, EMS providers, and hospital-based healthcare workers may be beneficial to support their mental health and well-being.
- Management of cardiac arrest in pregnancy focuses on maternal resuscitation, with preparation for early perimortem cesarean delivery if necessary to save the infant and improve the chances of successful resuscitation of the mother.
Updates in the ratio of rescue breath in pediatrics:
The 2015 guidelines recommended traditional CPR cycles of 30 chest compressions to two rescue breaths for one-rescuer CPR in all age groups and for two-rescuer CPR in adults.
The 15:2 ratio of compressions to breaths that was presented in the 2015 guidelines only for use in two-rescuer CPR for children and infants is now the recommended assisted ventilation rate for all pediatric resuscitation scenarios (rescue breathing or advanced airway). This will increase the respiratory rate to 20-30 breaths per minute by having 1 breath every 2 to 3 seconds.