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AHA Updates Guidelines in 2019 (Part 3): No change to basic life support steps

Updated: Feb 13, 2022

We introduced and summarized the 2019 American Heart Association (AHA) guideline updates most-pertinent to safety professionals in Parts 1 and 2 of this 3-part series. In Part 3 we recall AHA’s accepted steps and techniques for adult, child and infant Basic Life Support (BLS). Although BLS was excluded from 2019 revisions its significance to the chain of survival warrants review.

Fundamentals of BLS []

Fundamental aspects of BLS include immediate recognition of sudden cardiac arrest and activation of the emergency response system (9-1-1), early cardiopulmonary resuscitation (CPR), and rapid defibrillation with an automated external defibrillator (AED).

A key component influencing BLS fundamentals is circulation. That’s why in 2010 new data supporting the importance of circulation ahead of ventilation prompted significant modifications to the order of BLS steps from “A-B-C” (airway, breathing, compression) to “C-A-B” (compression, airway, breathing). Circulation-focused “C-A-B” response remains the rule in 2020 and applies to any and all resuscitation providers.

Basic Life Support Guidelines for High Quality CPR (

The Future of First Aid and Resuscitation Science

Sudden cardiac arrest remains a leading cause of death in the United States.

  1. 70% of out-of-hospital cardiac arrests (OHCAs) occur in the home, and approximately 50% are unwitnessed.

  2. Outcome from OHCA remains poor: only 10.8% of adult patients with nontraumatic cardiac arrest who have received resuscitative efforts from emergency medical services (EMS) survive to hospital discharge.

  3. In-hospital cardiac arrest (IHCA) has a better outcome, with 22.3% to 25.5% of adults surviving to discharge.

The International Liaison Committee on Resuscitation (ILCOR) warns that despite significant advances in the field of resuscitation science, important knowledge gaps persist. In response, the AHA has opted for more frequent reviews and updates of their literature that support the latest emerging data and science. As a result, guidelines are now updated on an on-going basis as opposed to every five years.

It is highly recommended that certified lay rescuers stay informed of AHA guideline changes between recertification¹ years.


¹ The American Heart Association requires recertification training every 2 years to maintain a valid course completion card

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