This graphic from the American Heart Association illustrates its 2010 CPR guidelines, which emphasize chest compressions after collapse.

AHA, ERC Issue New CPR Guidelines

They emphasize performing compressions before rescue breathing and using automated external defibrillators early.

The 2010 cardiopulmonary resuscitation guidelines were posted Monday by the American Heart Association and the European Resuscitation Council, offering clear support for early defibrillation using an AED and also for immediate compressions by lay bystanders. These are the first update since 2005. AHA and the ERC are founding members of ILCOR, the International Liaison Committee on Resuscitation.

"Push fast and firmly, and start immediately," said Professor Bernd Bottiger, chairman of the ERC. "If the victim does not respond or react, press down at least five centimeters on the middle of the chest, at a rate of at least 100 compressions per minute."

The guidelines make it clear that chest compressions, whether by trained or untrained bystanders, are more important than rescue breathing. Bystanders who are trained and willing should combine the two at a ratio of 30 compressions to two breaths, according to the ERC guidelines. Compressions are paramount because even without rescue breathing, the sudden cardiac arrest victim will suffer irreversible brain damage within five minutes after collapse without compressions.

The new ERC Guidelines clearly recommend using AEDs because early defibrillation, in addition to chest compressions, may save the lives of many SCA victims. These guidelines also recommend cooling the arrest victim to 32-34 degrees C (89.6 to 93.2 degrees F) for 12 to 24 hours because this significantly increases the chance of good neurological survival.

About 500,000 people in Europe suffer a sudden cardiac arrest every year. "We will save 100,000 lives per year in Europe if all -- lay and professional people -- take part in this way and care," Bottiger said.

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