2019 AHA Guidelines: Updated Guidelines for CPR and ECC

By: Cascade Training | Posted on: Jan 15, 2020

Cardiovascular disease is the number one cause of death in the United States. More than one million coronary events—including heart attacks—were expected to occur in 2019, including 720,000 new events; many events will occur outside hospital walls. Even more disturbing, 90 percent of cardiac arrest victims will not survive.

Getting cardiopulmonary resuscitation (CPR) training from an approved AHA (American Heart Association) administrator could help you save a life someday. Cascade Training Center offers courses in CPR and ECC (emergency cardiovascular care) that follow AHA guidelines.

In 2019, the American Heart Association updated its guidelines on CPR and for AHA Emergency Cardiovascular Care resuscitation experts. They now require that instruments and training devices provide voice directed, specific and real-time expert feedback for students and instructors. Scientific data supports the idea that training devices and Automated External Defibrillators (AEDs) along with coaching feedback will help students understand what high-quality CPR feels like.

The AHA revised their recommendations on the use of advanced airways, vasopressors, and extracorporeal cardiopulmonary resuscitation only during cardiac arrest. They include the choice of devices and strategies used, required training and retraining, administration of standard-dose epinephrine and the potential impact of extracorporeal cardiopulmonary resuscitation on cardiac arrest survival. The update suggests that BMV (bag-mask ventilation) without an advanced airway device might not be enough to resuscitate patients and protect against pulmonary aspiration.


The AHA also updated guidelines on systems of care for dispatcher-assisted (DA) cardiopulmonary resuscitation (CPR) and cardiac arrest centers (CACs). These are based on reviews requested by the International Liaison Committee on Resuscitation (ILCOR) Basic Life Support Task Force and showed better outcomes for patients when DA-CPR was administered in out-of-hospital cardiac arrest cases. The update also supports using DA-CPR on pediatric patients as indicated by the Consensus on Science with Treatment Recommendations (CoSTR) summary. Council-specific guidelines also recommend that emergency medical dispatch centers offer DA-CPR for presumed pediatric cardiac arrest, especially when no bystander is in the process of administering CPR.

In summary, the AHA updates recommend:

  • Considering either BMV or an advanced airway strategy during adult CPR
  • Using an SGA (supraglottic airway) strategy can be applied with an advanced airway in out-of-hospital settings with low tracheal intubation success rates or minimal training opportunities
  • Either SGA or ETT (endotracheal intubation) strategy can be used with an advanced airway in out-of-hospital settings with high tracheal intubation success rates or optimal training opportunities
  • Either SGA or ETT strategy can be used with an advanced airway in hospital settings by expert providers who have been trained in these procedures
  • Frequent training or retraining for providers who perform ETI (endotracheal intubation)
  • Ongoing programs of quality improvement for EMS systems that perform prehospital intubation to minimize complications and track ETI and SGA placement success

    Cascade Training Centers offer a broad range of CPR (and more) courses at locations in Oregon, Washington and California for both healthcare professionals and lay people. Since 2002, Cascade has credentialed more than 100,000 people per year, offering customized training and compliance programs, as well as more than 20 nationally validated certification courses.