The much-anticipated 2015 American Heart Association (AHA) guidelines have arrived. I applaud the work in reviewing science and developing a collaborative statement. It is a formidable task. I am also amazed, that despite the number of people involved, the AHA rarely has any major information leaks before the release of the guidelines.
The changes in the guidelines, unlike the previous updates, are less likely to impact my work as an educator, author and app publisher. A major amount of written and electronic material needs to be reviewed to ensure it matches the 2015 AHA guidelines. Failing to revise promptly is looked upon negatively while flying the “Meets 2015 AHA Guidelines” banner is publishing gold.
Or is it?
Updating books, apps and tests
Has anything dramatically changed, requiring urgent updates of educational materials?
For example:
- Compression rate is now 100/ to 120/minute. They were at least 100. So if a student chose 100 on a test they would be correct.
- Compression depth is now 2 to 2.4 inches. It was 2 inches. Choosing 2 inches is still a correct answer.
- We now know that if we have an AED present in a witnessed arrest we should shock immediately. If it wasn’t witnessed, do CPR while setting up the AED. We have been teaching this for 5 years.
- Medical directors and educators have already embraced the importance of compressions and in many cases high-performance or pit-crew CPR.
In addition the guidelines give us more consistency around the adult and pediatric spectrums of resuscitation. But still, when compared to previous releases, nothing revolutionary has changed at the BLS level.
My prediction is that the NREMT will have to only make minimal changes to its question database to account for the 2015 guidelines. Since the NREMT cognitive examination is largely decision-based questions, I don’t believe these small factual changes will affect things much.
More frequent updates
In the future I hope we see regular updates rather than releases on a five-year cycle. In the weeks leading up to the guideline release there were two papers published by the AHA; an advisory statement on targeted temperature management and a 47-page “Cardiac Arrest in Pregnancy” scientific statement.
I hope the release of these statements is a foreshadowing of the AHA to come: relevant guidance released as it is available rather than a major event every 5 years.
It is time to make resuscitation updates less about publishing cycles — both AHA materials and other published products — and more about the timely release of good clinical information. EMS needs to adopt a mature approach to science in recognizing that change isn’t every 5 years. It is constant.
