The American Heart Association (AHA) updated its guidelines for CPR and emergency cardiovascular care on Oct. 15 with an emphasis on training bystanders and healthcare providers and using mobile technology to alert dispatchers after noticing someone is suffering from cardiac arrest.

Each year, more than 326,000 people have cardiac arrest outside of a hospital and approximately 90 percent of them die, according to the AHA. The guidelines were last updated in 2010.

Since then, technology changes have had a major impact on CPR and emergency care, according to Clifton Callaway, MD, PhD, chair of the AHA’s Emergency Cardiovascular Care committee and professor of emergency medicine at the University of Pittsburgh.

Callaway mentioned there are cell phone applications where an alarm goes off if someone needs CPR nearby. Commercial vendors and cities have implemented similar programs to promote bystander CPR.

“The guidelines acknowledge that there are increasingly point-of-care and just-in-time information and things we can do to get emergency response and emergency care to people that probably didn’t exist 10 or 15 years ago,” Callaway told Cardiovascular Business.

The guidelines also mention the use of hands-only CPR, which involves no mouth-to-mouth contact. They also stress the importance of having 911 dispatchers provide instructions to a bystander or a willing citizen to perform CPR immediately.

“It takes a while to learn CPR well,” Callaway said. “Practice makes you better, but we have over the past few years looked at how well will people respond and how much can they do with just-in-time training or having only seen a video or only seen a public service announcement. It’s clear, and the guidelines acknowledge, that having seen something or having somebody coach you on the phone, you are able to do something like hands-only CPR, which can be much better than doing nothing at all.”

Emergency physicians and other providers should also increase their CPR training, according to the guidelines. Callaway said emergency providers are required to undergo CPR training every year or two, but that could change.

“[CPR] is integral to our job,” he said. “What I think is spelled out better now is that we should expect as professionals to practice these skills more often. Somewhere between practicing every day and practicing every two years is probably a sweet spot of maintenance of skill. We’re actively exploring educational platforms that would let people practice a little bit in small doses more frequently to maintain skill and maintain competency.”

Callaway defined cardiac arrest as occurring when the heart stops or has an irregular rhythm and becomes unable to pump blood. The guidelines reinforce that it is important to perform CPR as soon as possible.

“Bystander CPR and the general public being able to respond quickly is so important,” Callaway said. “It’s a major theme in our guidelines. The system of care starts with the average citizen. That person’s rapid action can be one of the most important parts of the whole system of care.”