December 9, 2005

Hazinski helps revise national CPR guidelines

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Mary Fran Hazinski, M.S.N., R.N., helped craft the American Heart Association’s new CPR guidelines.
photo by Neil Brake

Hazinski helps revise national CPR guidelines

Mary Fran Hazinski, M.S.N., R.N., a clinical nurse specialist in pediatric emergency and critical care at the Monroe Carell Jr. Children's Hospital at Vanderbilt, has been at the heart of efforts to prepare the recently released new national guidelines for performing cardiopulmonary resuscitation, or CPR.

She served as co-editor of an international science review and editor of the American Heart Association's new guidelines, which outline sweeping changes to how lay people and medical professionals will be trained to resuscitate those in cardiac arrest.

“This 2005 version of the resuscitation guidelines represents the most substantial revision since the first guidelines were published,” said Hazinski, also senior science editor for Emergency Cardiovascular Care at AHA.

“The process began in 2002 with the initiation of an international science review. The science review was sponsored by the International Liaison Committee on Resuscitation, an organization of international resuscitation councils.

“It ultimately involved 380 of the world's resuscitation experts who reviewed more than 22,000 peer-reviewed publications and discussed their findings during six international meetings.”

Hazinski co-edited the summary of that science review, published in both Circulation and Resuscitation, with Jerry Nolan, M.D., a critical care physician from the U.K.

The new AHA guidelines were released electronically Nov. 28 and will be published on Dec. 13 in the journal Circulation.

“The major changes in the AHA Guidelines are designed to ensure that more victims of cardiac arrest receive effective CPR,” Hazinski said. “It's 'back to the basics' with simplified guidelines, emphasizing effective chest compressions. Even recommendations for health care providers are designed to provide longer periods of uninterrupted chest compressions.”

One example is the increase in the compression-to-ventilation ratio. For an adult victim, lay or professional responders should perform CPR with a ratio of 30 compressions to 2 breaths. This in effect doubles the number of compressions given before interruption for breaths. The compression-to-ventilation ratio for children is 30-to-2 for single rescuers and 15-to-2 for two rescuers.

“A big impetus for revision was that the average survival rate from cardiac arrest nationwide has not improved in 20 years, yet we have seen very high survival rates in some lay rescuer CPR and AED programs. Reports from such programs have given us more information about the relative benefits of early CPR and early defibrillation,” Hazinski said.

She said that scientists looked at published results from programs such as those at large airports and at casinos in Las Vegas, where high cardiac arrest survival rates have been reported. In those programs with the best survival, victims received both immediate bystander CPR and shock delivery within five minutes of collapse. The AHA experts devised recommendations to encourage more bystander CPR and early defibrillation.

“I am honored to be a part of this publication,” Hazinski said. “I learned a lot and I came away with renewed enthusiasm for CPR programs. There is more research being performed and published about CPR than in the past, and this research shows that CPR works. In addition, new technology may soon be available to aid rescuers in improving CPR during resuscitation.”

The guidelines are detailed on the AHA's Web site,