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What are the 2015 CPR recommendations for bystanders?

Bystanders should first call 911. Untrained bystanders should perform Hands-Only — or compression-only — CPR, which remains an effective tool in saving lives from cardiac arrest. However, the new guidelines recommend that if a bystander is trained in CPR and can perform breaths, he or she should add breaths in a cycle of 30 compressions and two breaths.

What other key updates have been made to the 2015 CPR and emergency cardiovascular care guidelines?

The chest compression rate and depth have been updated. In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120 compressions per minute to a depth of at least 2 inches for an average adult, while avoiding excessive chest compression depths of greater than 2.4 inches.

There is also now an emphasis on the use of mobile technologies by bystanders to aid in calling 911 sooner and receiving dispatch-assisted CPR instructions. Mobile technology and social media applications that notify rescuers of a nearby cardiac arrest may increase the rate of bystander-initiated CPR. Bystanders should use mobile phones to immediately call 911, placing the phones on speaker so the dispatcher can help bystanders check for breathing, get the precise location and provide instructions for performing CPR.

Why are there new limits for depth and rate of chest compressions?

The upper limits of recommended compression rate and depth are based on preliminary data that suggest excessive compression rate and depth adversely affect outcomes.

What are the key recommendations for children?

For infants and children, the guidelines reaffirm the C-A-B (compressions, airway, breathing) sequence and that compressions and ventilation are needed for pediatric cardiac arrest. Compressions should be done at a rate of 100 to 120 compressions per minute at a depth of about 1.5 inches for infants, about 2 inches for children and at least 2 inches but no greater than 2.4 inches for adolescents. If rescuers are unwilling or unable to deliver breaths, they should perform compression-only CPR.

What is the new “Systems of Care” chapter?

This recommendation emphasizes that everyone has a role to play in cardiac arrest survival. The guidelines are taking the first steps to help have a universal system of care that communities can implement.