ARLINGTON, Texas — A senior associate dean in the UTA College of Nursing and Health Innovation played a chief role in developing the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, which among other things, calls for quick action on the part of bystanders.
Dr. Beth Mancini served as lead author of Part 3 of the AHA document and intimately understands the significance of CPR. It’s a painful lesson that she experienced as a child and the reason that she passionately advocates for CPR training worldwide.
“We were at home when my 50-year-old dad suffered sudden cardiac arrest,” Dr. Mancini said. “I was 16 at the time and unable to perform CPR. I stood by him and had to wait for someone to come and help, but he didn’t survive.” A year later, her mother died after complications of cardiac surgery.
Dr. Mancini says she never wants anyone else to go through what she endured and has devoted her career to helping others prevent errors and enhance patient safety. The 2015 guidelines continue to encourage immediate bystander CPR that maximize an individual’s chances for survival.
“We know that when an adult collapses, motivating people to respond, to put their hands on the chest and push hard and fast, is important,” she said. “That’s what saves lives. A bystander can jump into action, call 911 and start CPR.”
Dr. Anne Bavier, dean of the UTA College of Nursing and Health Innovation and recently installed president of the National League for Nursing, said Dr. Mancini’s research positions UTA nursing faculty members as a go-to resource for leading international health organizations, such as the American Heart Association.
“It is an honor for the University to have leaders such as Dr. Mancini, who turned a childhood experience into a passion that has benefited untold thousands worldwide,” Dr. Bavier said. “Dr. Mancini’s focus on evidence as these guidelines become updated means that all members of society have an opportunity to learn from a tragic incident in her life. This is the best of nursing – the passion for healthcare and the reason we exist.”
Dr. Mancini’s research is one of the critical areas of universal significance supported by UTA’s focus on health as the University implements its Strategic Plan 2020: Bold Solutions | Health and the Human Condition .
Cardiac arrest is a leading cause of death in the U.S. According to the AHA, more than 326,000 people annually experience cardiac arrest outside of a hospital, and more than 90 percent of them die. Administration of CPR at the scene of a cardiac event dramatically increases chances of survival.
While this year’s AHA guidelines emphasize the need for high quality training of bystanders as well as health professionals, there is a strong message that bystanders should not hesitate to act. According to the 2015 Guidelines Update, individuals who have not been trained in CPR should call 911, and then provide hands-only CPR, or CPR without breaths, pushing hard and fast at a rate of 100 to 120 compressions per minute, until Emergency Medical Services arrive. Information about this can be found at: http://cpr.heart.org/AHAECC/CPRAndECC/Programs/HandsOnlyCPR/UCM_473196_Hands-Only-CPR.jsp . Bystanders who have been trained in CPR can add breaths in a 30:2 compressions-to-breaths ratio.
The 2015 guidelines also recommend that bystanders place mobile phones on speaker when calling 911. This frees up hands, and allows better communication with dispatchers, who can provide instructions in how to check for breathing, how to recognize signs of cardiac arrest, and how to administer compressions. The goal of guidelines for bystanders is to provide immediate CPR to all victims of cardiac arrest.
The AHA first published guidelines for cardiovascular resuscitation in 1966. The guidelines are updated every five years based on the most current scientific evidence. In addition to providing guidance in administration of bystander CPR, they include extensive recommendations for training of health care professionals, and for treating cardiovascular emergencies in adults, children, infants and newborns.
“Updating guidelines every five years is important to the general population and healthcare providers,” Dr. Mancini said. “By reviewing the literature on resuscitation in a systematic way, we can refine the guidelines and recommendations so that everybody is working with the best available information.”
Dr. Mancini’s work with the American Heart Association spans nearly four decades. She volunteered with the organization when she served as a nurse in 1976. Her relationship grew as she took on a number of roles at the statewide, national and international level. During this time, she also was named a fellow of the American Heart Association and National League for Nursing’s prestigious Academy of Nursing Education. In addition to CPR practices and policy, her research expertise includes emergency and critical care nursing, improving physician and nurse communication with serious gaming, patient safety and simulation.
She acknowledged that her life’s work and research directly correlates to the unique education that the College of Nursing and Health Innovation provides to students pursuing health-related professions.
“I’ve been able to help bring a number of resuscitation research studies to UTA including several focused on how students learn to perform CPR and how they best retain those skills,” she said. “Unless you work in areas such as a hospital emergency room, you don’t use these skills frequently; so how do we maximize retention of CPR skills when we know patient outcome relates to the quality of CPR performed? These studies speak to the commitment of the research, and evidence-based practice and nursing research that UTA is known for.”
Almost 200,000 cardiac arrests occur in hospitals annually. Resuscitation skills can decline with a short period of time, and according to the AHA, frequent training is one key to ensuring that hospitals deliver the highest quality of emergency cardiovascular care. Dr. Mancini indicated that for health professionals, the 2015 AHA Guidelines Update focuses on the quality of CPR performed, and on the care of the patient once spontaneous circulation has been restored.
In addition to providing ethical guidelines for health professionals working with patients and families at the end of life, Dr. Mancini also served on a working group of the International Liaison Committee on Resuscitation that established recommendations for future educational programs related to CPR and advanced life support. Both sets of guidelines are published in the journal Circulation: Journal of the American Heart Association .
The International Liaison Committee on Resuscitation met for the first time in 1992. The meeting brought together organizations from around the world to review current research regarding resuscitation, and to arrive at consensus treatment recommendations. The organizations that are part of ILCOR are the American Heart Association, the Australian and New Zealand Committee on Resuscitation, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Inter-American Heart Foundation, the Resuscitation Council of Asia, and the Resuscitation Council of South Africa.
