American Heart Association Guidelines Update Research Articles

Knowledge on American Heart Association Guidelines Update for Cardiopulmonary Resuscitation among the Nurses Working at University Hospital, Kavre

Background Cardiopulmonary resuscitation is the foundational technique for the emergency treatment of cardiac arrest and the standardized training of it has been emphasized more than ever. Competence of the nurses in this lifesaving procedure is a critical factor in patient outcome from cardiac arrest and can largely prevent sudden death. Objective Many evidences suggest lack of knowledge on proper cardiopulmonary resuscitation among nurses so the aim of this study was to assess the knowledge on 2015 American Heart Association guidelines update for cardiopulmonary resuscitation among nurses working at University hospital and to identify the relationship between the level of knowledge and selected variables. Method Two hundred and sixty nurses working in Dhulikhel hospital participated in the study. A cross-sectional descriptive study was conducted using a predesigned questionnaire based on 2015 guidelines updates for cardiopulmonary resuscitation that incorporated total of 20 questions. Result Total 260 participated in the study and all were female. Only one third of the nurses had good knowledge regarding 2015 guidelines update for cardiopulmonary resuscitation. No significant results existed between the knowledge score and age of the nurses, duration of work experience. However, significant results existed between the knowledge score and qualification, designation of the nurses and previous training on cardiopulmonary resuscitation. Conclusion One third of the nurses had good knowledge regarding 2015 guidelines update for cardiopulmonary resuscitation in this study. Thus, knowledge and practical approach has to be updated with current guidelines in cardiopulmonary resuscitation in order to improve the safety and effectiveness of patient care.

Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

1. Newborn resuscitation requires anticipation and preparation by providers who train individually and as teams. 2. Most newly born infants do not require immediate cord clamping or resuscitation and can be evaluated and monitored during skin-to-skin contact with their mothers after birth. 3. Inflation and ventilation of the lungs are the priority in newly born infants who need support after birth. 4. A rise in heart rate is the most important indicator of effective ventilation and response to resuscitative interventions. 5. Pulse oximetry is used to guide oxygen therapy and meet oxygen saturation goals. 6. Chest compressions are provided if there is a poor heart rate response to ventilation after appropriate ventilation corrective steps, which preferably include endotracheal intubation. 7. The heart rate response to chest compressions and medications should be monitored electrocardiographically. 8. If the response to chest compressions is poor, it may be reasonable to provide epinephrine, preferably via the intravenous route. 9. Failure to respond to epinephrine in a newborn with history or examination consistent with blood loss may require volume expansion. 10. If all these steps of resuscitation are effectively completed and there is no heart rate response by 20 minutes, redirection of care should be discussed with the team and family. It is estimated that approximately 10% of newly born infants need help to begin breathing at birth,1–3 and approximately 1% need intensive resuscitative measures to restore cardiorespiratory function.4,5 The neonatal mortality rate in the United States and Canada has fallen from almost 20 per 1000 live births6,7 in the 1960s to the current rate of approximately 4 per 1000 live births. The inability of newly born infants to establish and sustain adequate or spontaneous respiration contributes significantly to these early deaths and to the burden of adverse neurodevelopmental outcome among survivors. Effective and timely resuscitation …

The impact of a multidisciplinary debriefing protocol after in-hospital cardiac arrest on healthcare provider perspectives

Introduction: The American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care from 2015 recommend the implementation of performance-focused debriefing after in-hospital cardiac arrest events (class IIa). However, debriefing sessions are under-utilized and few studies have assessed their impact on healthcare providers’ perception of in-hospital resuscitation events.

Risk of bias assessment of randomised controlled trials referenced in the 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care: a cross-sectional review

ObjectivesTo identify the risk of bias of randomised controlled trials (RCTs) referenced in the 2015 American Heart Association (AHA) guidelines update for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC).DesignA...

2018 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

This 2018 American Heart Association focused update on pediatric advanced life support guidelines for cardiopulmonary resuscitation and emergency cardiovascular care follows the 2018 evidence review performed by the Pediatric Task Force of the International Liaison Committee on Resuscitation. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the group completes a literature review based on new published evidence. This update provides the evidence review and treatment recommendation for antiarrhythmic drug therapy in pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. As was the case in the pediatric advanced life support section of the "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care," only 1 pediatric study was identified. This study reported a statistically significant improvement in return of spontaneous circulation when lidocaine administration was compared with amiodarone for pediatric ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. However, no difference in survival to hospital discharge was observed among patients who received amiodarone, lidocaine, or no antiarrhythmic medication. The writing group reaffirmed the 2015 pediatric advanced life support guideline recommendation that either lidocaine or amiodarone may be used to treat pediatric patients with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.

380 Risk of Bias Assessment among Randomized Controlled Trials Referenced in the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Cross-Sectional Review

Randomized controlled trials (RCTs) provide the most reliable evidence of the impact of medical intervention, however bias can invalidate the results of RCTs. This study aimed to identify the risk of bias of randomized controlled trials (RCTs) referenced in the 2015 American Heart Association (AHA) guidelines update for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC). All RCTs cited as references in the 2015 AHA guidelines update for CPR and ECC were extracted. After excluding non-human trials, crossover studies, cluster trials, etc, 2 reviewers assessed the risk of bias among RCTs included in this study. The Cochrane Collaboration’s tool for assessing the risk of bias in 6 domains (random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, and selective reporting) was used. A total of 166 RCTs were selected for analyses. Of these, 72.9% (121/166) had a high risk of bias for blinding of participants and personnel. Although a small proportion of the trials was at high risk of bias in the remaining 5 domains, 33.7% (56/166) had an unclear risk of bias for random sequence generation, and 45.2% (75/166) had an unclear risk of bias for blinding of outcome assessment. Additionally, among 5 domains of risk of bias excluding random sequence generation, the proportion of trials at unclear or high risk of bias in journals with a relatively high IF (≥5 and <10) and high IF (≥10) was lower than that in journals with a low IF (<5) The proportion of trials at unclear or high risk of bias was high in the 2015 AHA guidelines for CPR and ECC, especially for random sequence generation and blinding of participants/outcome assessment. This tendency was more prominent in journals with a low IF (<5). Risk of bias should be considered when interpreting and applying the CPR guidelines in the clinical setting.

2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age. Four large database studies were available for review, including 2 published after the "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Two demonstrated worse 30-day outcomes with chest compression-only CPR for children 1 through 18 years of age, whereas 2 studies documented no difference between chest compression-only CPR and CPR using chest compressions with rescue breaths. When the results were analyzed for infants <1 year of age, CPR using chest compressions with rescue breaths was better than no CPR but was no different from chest compression-only CPR in 1 study, whereas another study observed no differences among chest compression-only CPR, CPR using chest compressions with rescue breaths, and no CPR. CPR using chest compressions with rescue breaths should be provided for infants and children in cardiac arrest. If bystanders are unwilling or unable to deliver rescue breaths, we recommend that rescuers provide chest compressions for infants and children.

Correction to: Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

In the article by Callaway et al, “Part 8: Post–Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care,” which published ahead of print October …

Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section

To study the normal oxygen saturation trends and fetomaternal correlates in healthy term newborns within 30 min of life born by normal vaginal delivery (NVD) and elective cesarean section (CS). A cross-sectional study was conducted on 200 healthy term newborns born by NVD and elective CS at a tertiary care centre. Routine care as per the Neonatal Resuscitation Program (NRP) 2015 (Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part 13: neonatal resuscitation: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:S543-60) protocol was given and pre-ductal arterial oxygen saturation was assessed by pulse oximetry at different intervals after birth. The mean peripheral oxygen saturation (SpO2) was 85.4%, 90.8%, 94.1%, 95.7%, 96.7% and 97.4% at 5, 10, 15, 20, 25 and 30 min, respectively, after birth. Higher mean SpO2 was observed in NVD compared to elective CS (P<0.005). The mean time for SpO2 to reach >90% was 9.13 min in NVD and 12.31 min in elective CS (P<0.001). Maternal hemoglobin (Hb) (r=-0.15; P<0.01), birth weight (r=-0.125; P<0.05) and Apgar at 10 min (r=0.33; P<0.001) were significantly correlated with SpO2 of newborns at 10 min of life. Our study defines normal SpO2 levels in healthy term newborns in the first 30 min of life born by NVD and elective CS. Babies born by NVD had significantly higher SpO2 levels and attained SpO2 >90% faster than those born by elective CS. Maternal Hb, birth weight and Apgar at 10 min were significant factors affecting SpO2 levels of newborns at 10 min of life.

Cardiopulmonary resuscitation knowledge and attitude among general dentists in Kuwait.

Dentists as health care providers should maintain a competence in resuscitation. This cannot be overemphasized by the fact that the population in our country is living longer with an increasing proportion of medically compromised persons in the general population. This preliminary study aimed to assess the knowledge and attitude of general dentists towards cardiopulmonary resuscitation (CPR). A cross-sectional study was carried out among 250 licensed general dental practitioners working in ministry of health. Data were obtained through electronic self-administered questionnaire consisting of demographic data of general dentists, and their experience, attitude and knowledge about CPR based on the 2010 American Heart Association guidelines update for CPR. Totally 208 general dentists took part in the present study giving a response rate of 83.2%. Only 36% of the participants demonstrated high knowledge on CPR, while 64% demonstrated low knowledge. Participants' age, gender, nationality, years of experience, career hierarchy, and formal CPR training were associated significantly with CPR knowledge. Almost all the participants (99%) felt that dentists needed to be competent in basic resuscitation skills and showed a positive attitude towards attending continuing dental educational programs on CPR. This study showed that majority of general dental practitioners in Kuwait had inadequate knowledge on CPR. It was also found that CPR training significantly influenced the CPR knowledge of the participants. Therefore, training courses on CPR should be regularly provided to general dentists in the country.

The Last Recommendations for Pediatric Advanced Life Support: Analysis of the 2015 American Heart Association Guidelines Update

The Last Recommendations for Pediatric Advanced Life Support: Analysis of the 2015 American Heart Association Guidelines Update

Out of Hospital Cardiac Arrest: A Current Review of the Literature that Informed the 2015 American Heart Association Guidelines Update.

Out-of-Hospital cardiac arrest affects over 300,000 individuals in the US per year and is the third leading cause of death for Americans. Given the extent of this public health problem, investigations are ongoing to improve upon outcomes for patients who suffer cardiac arrest. In 2015, the American Heart Association issued an update to the 2010 Cardiopulmonary and Emergency Cardiovascular Care Guidelines.1 In this manuscript, we reviewed the literature that informed the major changes to the guidelines and present a concise review of the current literature that informs how patients who suffer a cardiac arrest are cared for in the pre-hospital, emergency department and in-hospital environment. Additionally, the new AHA guideline on Maternal Resuscitation will also be described.

Correction to: Part 10: Special Circumstances of Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

In the article by Lavonas et al “Part 10: Special Circumstances of Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care,” which published online October 15, 2015, …

Nurse Leaders as Disruptive Innovators in Cardiopulmonary Resuscitation Competency

Improving the rate of survival among the 209,000 patients with an in-hospital cardiac arrest (IHCA) each year in the United States 1 Merchant RM Yang L Becker LB for the American Heart Association Get with the Guidelines-Resuscitation Investigators et al. Incidence of treated cardiac arrest in hospitalized patients in the United States. Crit Care Med. 2011; 39: 2401-2406 Crossref PubMed Scopus (326) Google Scholar depends on the provision of high quality cardiopulmonary resuscitation (CPR). Leading health care advisories, such as those of the Institute of Medicine 2 Institute of Medicine; Graham R McCoy MA Schultz AM Strategies to Improve Cardiac Arrest Survival: A Time to Act. The National Academies Press, Washington, DC2015http://www.nap.edu/catalog/21723/strategies-to-improve-cardiac-arrest-survival-a-time-to-act Google Scholar and the American Heart Association (AHA), 3 Bhanji F Donoghue AJ Wolff MS et al. Part 14: education: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132 (Accessed December 31, 2015): S561-S573http://circ.ahajournals.org/content/132/18_suppl_2/S561.full.pdf1html Crossref PubMed Scopus (200) Google Scholar suggest that the current survival rate of 22.3% from IHCA 4 Girotra S Nallamothu B Spertus JA Li Y Krumholz HM Chan PS for American Heart Association Get With the Guidelines-Resuscitation Investigators Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012; 367: 1912-1920 Crossref PubMed Scopus (591) Google Scholar can be improved through organization- and systems-level continuous quality improvement initiatives. As a result of the high number of arrests with low survival rates and new initiatives focusing on continuous improvement, likely cardiac arrest and the provision of high quality CPR will be a Centers for Medicare & Medicaid core measure. Improving the rate of survival among the 209,000 patients with an in-hospital cardiac arrest (IHCA) each year in the United States 1 Merchant RM Yang L Becker LB for the American Heart Association Get with the Guidelines-Resuscitation Investigators et al. Incidence of treated cardiac arrest in hospitalized patients in the United States. Crit Care Med. 2011; 39: 2401-2406 Crossref PubMed Scopus (326) Google Scholar depends on the provision of high quality cardiopulmonary resuscitation (CPR). Leading health care advisories, such as those of the Institute of Medicine 2 Institute of Medicine; Graham R McCoy MA Schultz AM Strategies to Improve Cardiac Arrest Survival: A Time to Act. The National Academies Press, Washington, DC2015http://www.nap.edu/catalog/21723/strategies-to-improve-cardiac-arrest-survival-a-time-to-act Google Scholar and the American Heart Association (AHA), 3 Bhanji F Donoghue AJ Wolff MS et al. Part 14: education: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132 (Accessed December 31, 2015): S561-S573http://circ.ahajournals.org/content/132/18_suppl_2/S561.full.pdf1html Crossref PubMed Scopus (200) Google Scholar suggest that the current survival rate of 22.3% from IHCA 4 Girotra S Nallamothu B Spertus JA Li Y Krumholz HM Chan PS for American Heart Association Get With the Guidelines-Resuscitation Investigators Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012; 367: 1912-1920 Crossref PubMed Scopus (591) Google Scholar can be improved through organization- and systems-level continuous quality improvement initiatives. As a result of the high number of arrests with low survival rates and new initiatives focusing on continuous improvement, likely cardiac arrest and the provision of high quality CPR will be a Centers for Medicare & Medicaid core measure.

Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality

Reprint: The American Heart Association requests that this document be cited as follows: Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL, Meaney PA, Niles DE, Samson RA, Schexnayder SM. Part 11: pediatric basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation . 2015;132(suppl 2):S519–S525. Reprinted with permission of the American Heart Association, Inc. This article has been published in Circulation . This 2015 American Heart Association (AHA) Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) section on pediatric basic life support (BLS) differs substantially from previous versions of the AHA Guidelines.1 This publication updates the 2010 AHA Guidelines on pediatric BLS for several key questions related to pediatric CPR. The Pediatric ILCOR Task Force reviewed the topics covered in the 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations and the 2010 council-specific guidelines for CPR and ECC (including those published by the AHA) and formulated 3 priority questions to address for the 2015 systematic reviews. In the online version of this document, live links are provided so the reader can connect directly to those systematic reviews on the International Liaison Committee on Resuscitation (ILCOR) Scientific Evidence Evaluation and Review System (SEERS) website. These links are indicated by a superscript combination of letters and numbers (eg, Peds 709). We encourage readers to use the links and review the evidence and appendices. A rigorous systematic review process was undertaken to review the relevant literature to answer those questions, resulting in the 2015 International Consensus on CPR and ECC Science With Treatment Recommendations, “Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support.”2,3 This 2015 Guidelines Update covers only those topics reviewed as …

Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (Reprint).

Reprint: The American Heart Association requests that this document be cited as follows: de Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF, Sutton RM, Tijssen JA, Topjian A, van der Jagt E, Schexnayder SM, Samson RA. Part 12: pediatric advanced life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation . 2015;132(suppl 2):S526–S542. Reprinted with permission of the American Heart Association, Inc. This article has been published in Circulation . Over the past 13 years, survival to discharge from pediatric in-hospital cardiac arrest (IHCA) has markedly improved. From 2001 to 2013, rates of return of spontaneous circulation (ROSC) from IHCA increased significantly from 39% to 77%, and survival to hospital discharge improved from 24% to 36% to 43% (Girotra et al1 and personal communication with Paul Chan, MD, MSc, April 3, 2015). In a single center, implementation of an intensive care unit (ICU)–based interdisciplinary debriefing program improved survival with favorable neurologic outcome from 29% to 50%.2 Furthermore, new data show that prolonged cardiopulmonary resuscitation (CPR) is not futile: 12% of patients receiving CPR in IHCA for more than 35 minutes survived to discharge, and 60% of the survivors had a favorable neurologic outcome.3 This improvement in survival rate from IHCA can be attributed to multiple factors, including emphasis on high-quality CPR and advances in post-resuscitation care. Over the past decade, the percent of cardiac arrests occurring in an ICU setting has increased (87% to 91% in 2000 to 2003 to 94% to 96% in 2004 to 2010).4 While rates of survival from pulseless electrical activity and asystole have increased, there has been no change in survival rates from in-hospital ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT). Conversely, survival from out-of-hospital cardiac arrest (OHCA) has not …

Part 13: Neonatal Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (Reprint).

Reprint: The American Heart Association requests that this document be cited as follows: Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, Simon WM, Weiner GM, Zaichkin, JG. Part 13: neonatal resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(suppl 2):S543–S560. Reprinted with permission of the American Heart Association, Inc. This article has been co-published in Circulation . The following guidelines are a summary of the evidence presented in the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR).1,2 Throughout the online version of this publication, live links are provided so the reader can connect directly to systematic reviews on the International Liaison Committee on Resuscitation (ILCOR) Scientific Evidence Evaluation and Review System (SEERS) website. These links are indicated by a combination of letters and numbers (eg, NRP 787). We encourage readers to use the links and review the evidence and appendices. These guidelines apply primarily to newly born infants transitioning from intrauterine to extrauterine life. The recommendations are also applicable to neonates who have completed newborn transition and require resuscitation during the first weeks after birth.3 Practitioners who resuscitate infants at birth or at any time during the initial hospitalization should consider following these guidelines. For purposes of these guidelines, the terms newborn and neonate apply to any infant during the initial hospitalization. The term newly born applies specifically to an infant at the time of birth.3 Immediately after birth, infants who are breathing and crying may undergo delayed cord clamping (see Umbilical Cord Management section). However, until more evidence is available, infants who are not breathing or crying should have the cord clamped (unless part of a delayed cord clamping research protocol), so that resuscitation measures can …

Copublishing of the Pediatric and Neonatal Portions of the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations and the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Copublishing of the Pediatric and Neonatal Portions of the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations and the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Part 10: Special Circumstances of Resuscitation

This Part of the 2015 American Heart Association (AHA) Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) addresses cardiac arrest in situations that require special treatments or procedures other than those provided during basic life support (BLS) and advanced cardiovascular life support (ACLS). This Part summarizes recommendations for the management of resuscitation in several critical situations, including cardiac arrest associated with pregnancy (Part 10.1), pulmonary embolism (PE) (10.2), and opioid-associated resuscitative emergencies, with or without cardiac arrest (10.3). Part 10.4 provides recommendations on intravenous lipid emulsion (ILE) therapy, an emerging therapy for cardiac arrest due to drug intoxication. Finally, updated guidance for the management of cardiac arrest during percutaneous coronary intervention (PCI) is presented in Part 10.5. A table of all recommendations made in this 2015 Guidelines Update as well as those made in the 2010 Guidelines is contained in the Appendix. The special situations of resuscitation section (Part 12) of the 2010 AHA Guidelines for CPR and ECC 1 covered 15 distinct topic areas. The following topics were last updated in 2010: Additional information about drowning is presented in Part 5 of this publication, “Adult Basic Life Support and Cardiopulmonary Resuscitation Quality.” The recommendations in this 2015 Guidelines Update are based on an extensive evidence review process that was begun by the International Liaison Committee on Resuscitation (ILCOR) with the publication of the ILCOR 2010 International Consensus on CPR and ECC Science With Treatment …