A single rescuer may now use 2 thumbs or the heel of 1 hand for infant compressions
2020 (New): for infants, single rescuers (whether lay rescuers or healthcare providers) should compress the sternum with 2 fingers or 2 thumbs placed just below the nipple line (mammary line).2020 (New): For infants, if the rescuer is unable to achieve guideline-recommended depths (at least one third the diameter of the chest), it may be reasonable to use the heel of one hand. Why: Systematic reviews suggest that the 2-thumb – encircling hands technique may improve CPR quality when compared with 2-fingers compressions, particularly for depth. However, there are limited data comparing the various hand pos
These guidelines are based on the most current and comprehensive review of resuscitation science, systems, protocols, and education.
A heart attack happens about every 40 seconds in the U.S., and the most common heart attack is caused by a complete blockage in a coronary artery, called ST-elevation myocardial infarction (STEMI). STEMI patients are most often treated with PCI, also known as angioplasty with stent, in which a catheter with a deflated balloon is inserted into the narrowed heart artery. Subsequently, the balloon is inflated, which clears the obstruction and restores blood flow. A stent is then inserted to keep the artery open.
“We know the time to opening the blocked coronary artery with PCI in heart attack patients is an important indicator for how a patient does after their heart attack. There are two measures for this time. One is symptom-to-balloon time, which is before the patient arrives to the hospital after symptoms start, to when that patient has a PCI; second is door-to-balloon time, the time from hospital arrival to PCI,” said study author Gregg W. Stone, M.D., director of academic affairs at Mount Sinai Heart Health System in New York City. “We focused on heart attack size, or damage, with both time measures and found symptom-to-balloon time was by far the more important.”
“During the peaks of the COVID-19 pandemic, hospitals are reporting fewer people coming into the emergency room for heart attack and stroke symptoms – indicating people aren’t calling 911, or they are delaying or avoiding critical care,” Elkind said. “This concerns us because we know it’s very unlikely that there are fewer heart attacks or strokes occurring. These new findings emphasize just how crucial it is to call 911 at the first sign of a heart attack or stroke – because getting quick treatment can be the difference between life and death. As we have been urging even during the COVID-19 pandemic, don’t die of doubt. Call 911 as soon as possible.”
Co-authors are Björn Redfors, M.D., Ph.D.; Reza Mohebi, M.D.; Gennaro Giustino, M.D.; Shmuel Chen, M.D., Ph.D.; Harry P. Selker, M.D., M.S.P.H.; Holger Thiele, M.D.; Manesh R. Patel, M.D.; James E. Udelson, M.D.; E. Magnus Ohman, M.D.; Ingo Eitel, M.D.; Christopher B. Granger, M.D.; Akiko Maehara, M.D.; Ziad A. Ali, M.D., D.Phil.; Ori Ben-Yehuda, M.D. Author disclosures are in the manuscript. The researchers reported no funding sources for this study.
Common heart attack warning signs:
Learn more at Heart.org/HeartAttack
copyright American Heart Association 2021