The American Heart Association has issued new guidelines rearranging the ABCs of cardiopulmonary resuscitation (CPR).

The guidelines now instruct rescuers to start with hard, fast heart compressions before giving mouth-to-mouth. Under the new approach, the old Airways-Breathing-Compression (A-B-C) sequence is changed to Compression-Airway-Breathing (C-A-B).

In the first few minutes of a cardiac arrest, victims will have oxygen remaining in their lungs and bloodstream, so starting CPR with chest compressions can pump that blood to the victim's brain and heart sooner. Research shows that rescuers who started CPR with opening the airway took 30 critical seconds longer to begin chest compressions than rescuers who began CPR with chest compressions.

The guidelines also instruct rescuers to push deeper, at least 2 inches in adults, and pump the victim's chest at least 100 times a minute.

The new guidelines apply to adults, children, and infants, but exclude newborns.

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