CPR gets instituted less in palliative care than in other medical streams, but it might still become necessary at times.

The American Heart Association has published new guidelines (Circulation. 2010;122:S640-S656, doi:10.1161/CIRCULATIONAHA.110.970889).

The following are some of the key elements of the revised guidelines:

• The AHA has rearranged the A-B-Cs (Airway-Breathing-Compressions) of CPR to C-A-B (Compressions-Airway-Breathing).
• Chest compressions are therefore the first step for lay and professional rescuers to revive an individual with sudden cardiac arrest.
• This change in CPR sequence applies to adults, children, and infants, but excludes newborns.
• “Look, Listen and Feel” has been removed from the basic life support algorithm.
• Rate of chest compressions should be at least 100 times a minute.
• Rescuers should push deeper on the chest, resulting in compressions of at least 2 inches in adults and children and 1.5 inches in infants.
• Between each compression, rescuers should avoid leaning on the chest so that it can return to the starting position.
• Rescuers should avoid stopping chest compressions and avoid excessive ventilation.
• Injection of atropine is no longer recommended in the treatment of asystole.

Read the full guidelines here – [PDF version]