3 Key Highlights of the AHA 2020 Guidelines
Catch up on some changes you may have missed during the pandemic and explore ways to train for them.
Catch up on some changes you may have missed during the pandemic and explore ways to train for them.
Since the first American Heart Association (AHA) Guidelines for CPR and Emergency Cardiovascular Care (ECC) were published in 1966, the healthcare community has continually turned to the AHA for the latest resuscitation science and recommendations available.
如果您是复苏的教育者,那么您可能会知道准则的重要性以及全部阅读它们的重要性。但if you’re like many of our clients, you may have struggled to focus on the current Guidelines published last year – because they were released in October, in the midst of the COVID-19 pandemic.
在下面,我们总结了三个新的指南建议,这些建议让我们的客户在谈论。我们还为如何根据2020年指南的复苏教育科学部分培训这些建议提供了一些建议。
The intravenous (IV) route has historically been the primary method of vascular access during resuscitation. However, it can be difficult to secure an IV, depending on the patient’s condition and experience of the practitioner. This difficulty can lead to delay in administering drugs or fluids to the patient.1
The intraosseous (IO) access method is an alternative to IV that has grown in popularity and is often used as a first-line approach to access because many providers find it quicker and easier to accomplish.2The previous 2015 AHA Guidelines did not make a recommendation for one method over the other.3
AHA’s new recommendations are thatit is reasonable for providers to first attempt establishing IV access, and IO access may be considered if attempts at IV access are unsuccessful or not feasible.4

Resusci Anne QCPRwith IV arm
Training tip:
IV insertion can be daunting and challenging for learners. Consider adopting components of the deliberate practice and mastery learning model to help learners perfect this psychomotor skill. Deliberate practice involves giving learners a distinct goal to accomplish; immediate feedback on their performance; and plenty of time for repetition to improve performance. Mastery learning involves using deliberate practice along with testing that uses set criteria to define a specific passing standard that implies mastery of the task being learned.5
AHA recommends combining repetition with individualized feedback based on assessments; assigning specific exercises to address areas for improvement; and providing learners with enough time to achieve the minimum passing standard.6
Paired with an IV arm task trainer or manikin with IV arm, this approach can help raise learner competence to an expert level.
为什么:
根据2020年的复苏教育科学科,incorporating a deliberate practice and mastery learning model may be considered for improving skill acquisition and performance.7证据表明,该模型作为BLS或ACLS课程的一部分,改善了多个学习成果。8

Resusci Anne QCPR与TeamReporter应用程序
双顺序除颤或几乎使用2个碎屑剂同时应用冲击,已成为一种日益流行的方法。该技术是基于“更多必须更好”的想法。9
However, the Guidelines advise thatthe usefulness of double sequential defibrillation for refractory shockable rhythms has not been established。Because evidence is lacking, it is premature for this method to be used in routine clinical practice.10
Given the unknowns around using the technique, consider focusing instead on a better-understood factor in defibrillation success: CPR quality.心肺复苏术defibrillati之前执行的质量on has been shown to affect clinical outcomes。11Specifically, longer pre-shock pauses and shallow chest compressions are associated with defibrillation failure.12如果未执行高质量的心肺复苏术,则双重顺序除颤很可能无法弥补。
Training tip:
Ensure your learners are contributing to the chances of achieving successful defibrillation. Run some drills and scenarios that require your learners to maximize time on the chest and perform quality compressions – in spite of whatever dynamics and variables the team encounters. This will provide the opportunity to practice individual skills as well as teamwork and communication. Consider gamifying these experiences with a competition: use CPR feedback technology to measure and score learners on their individual and team performance. Debriefing the experiences from start to finish will help identify areas for improvement.
为什么:
根据2020年的复苏教育科学科,团队合作培训和gamified opport学习unities to enhance resuscitation training and may improve learning outcomes。13评估团队和领导力培训作为ACLS培训的一部分的研究a positive impact on provider skills during simulated and real cardiac arrests。Improvements were seen in 1 or more aspects of clinical task performance during simulated events – including time to initiation of CPR and defibrillation.14研究游戏学习效果的研究表明,知识获取,知识保留和心肺复苏术的改善。15
啊哈现在建议这样做may be reasonable to use a respiratory rate of 1 breath every 2 to 3 seconds (20 to 30 breaths per minute)for infants and children who are either receiving CPR with an advanced airway in place or are receiving rescue breathing and have a pulse.16
As it is considerably higher than in previous Guidelines, this recommendation has spurred some concerns about overventilation among some members of the healthcare community.17Many Medical Directors have reviewed their own protocols in light of the new AHA Guidelines and have ensured that their personnel are sufficiently notified about local policies going forward.

Resusci Junior QCPR带气道头
Training tip:
Regardless of your position on increased ventilations, it’s important to be reinforcing the message now. Few events are as stressful for providers as一名儿科患者突然心脏骤停。在实际临床环境中进行的原位培训或培训提供了更现实的经验。通过让学习者有机会在同一环境中练习所需的通风率,可以帮助学习者感到更加准备。考虑使用提供高质量反馈的婴儿和儿童手持,以及促进高性能团队培训的工具,以创造丰富而全面的训练机会。
为什么:
根据2020年指南的复苏教育科学科,除传统培训外,还可以使用基于原位的基于原位的复苏教育。18Recent evidence indicates that when combined with other educational strategies,in-situ training has a positive impact on learning outcomes, performance change in the real clinical environment, and even patient outcomes。19
TeamReporter App
The mobile app designed for High-Performance CPR training with intelligent video debriefing.
Resusci Junior QCPR气道套件
A simple do-it-yourself upgrade kit for adding more advanced airway training capabilities to Resusci Junior QCPR.
Simpad Plus与Skill Reporter
QCPR feedback on a rugged, Laerdal-dedicated SimPad PLUS tablet. Additional features include CPR for Teams mode and ShockLink device connectivity.
SkillReporter app
SkillReporter App专为医疗保健响应者而设计和建造,为治疗婴儿,儿童和成人心脏骤停提供了新的精确培训。