Part 1: Introduction This publication presents the 2005 American Heart Asso- the evidence review, and (3)draft treatment recommenda- ciation(AHA)guidelines for cardiopulmonary resusci- tions. They then completed worksheets that provided the tation( CPR)and emergency cardiovascular care(ECC). The format for a structured literature review (Table 1).The guidelines are based on the evidence evaluation from the worksheet authors identified key research studies, recorded 2005 International Consensus Conference on Cardiopulmo- the levels of evidence(Table 2)of the studies, and drafted nary Resuscitation and Emergency Cardiovascular Care Sci- recommendations. When possible, two worksheet authors ence With Treatment Recommendations, hosted by the Amer- one from the United States and one from outside the United ican Heart Association in Dallas, Texas, January 23-30, States, were recruited to complete independent reviews of 2005. These guidelines supersede the Guidelines 2000 for each topic. This process is described in detail in the 2005 Cardiopulmonary Resuscitation and Emergency Cardiova International Consensus on Cardiopulmonary Resuscitation ular Care. 2 and Emergency Cardiovascular Care Science With Treat As with all versions of the ECC guidelines published since ment Recommendations' and the accompanying editorial. 7 1974,2-6 the 2005 AHA Guidelines for CPR and ECC contain A total of 281 worksheet authors completed 403 work- recommendations designed to improve survival from sudden sheets on 276 topics. To obtain feedback from the resuscita- cardiac arrest and acute life-threatening cardiopulmonary on sc ience community, in December 2004 the workshe problems. These guidelines, however, differ from previous and worksheet author conflict of interest disclosures were versions in several ways. First, they are based on the most postedontheInternetathttp://www.C2005.org.JOurnal extensive evidence review of CPR yet published. Second, advertisements and emails invited comment from healthcare these guidelines were developed under a new structured and professionals and the resuscitation community. The com- transparent process for ongoing disclosure and management ments were then referred to the task forces and worksheet of potential conflicts of interest. Third, the guidelines have authors for consideration. Worksheets are available through been streamlined to reduce the amount of information that http://www.c2005.org. rescuers need to learn and remember and to clarify the most Expert reviews began in 2002, and individual topics were important skills that rescuers need to perform. presented and discussed at 6 international meetings, culmi- Evidence evaluation process nating in the 2005 Consensus Conference. The evidence was presented, discussed, and debated, with task forces an The evidence evaluation process that was the basis for these resuscitation councils meeting daily to draft summaries. The guidelines was accomplished in collaboration with the Inter consensus statements on the science of resuscitation devel- national Liaison Committee on Resuscitation (ILCOR). international consortium of representatives from many of the oped at the conference were incorporated into the ILCOR 2005 CPR Consensus, published simultaneously in Circula- world's resuscitation councils. ILCOR was formed to system- tion and Resuscitation in November 2005 suscitation s cience and develop an evidence-based consensus to guide resuscitation pract Guidelines and treatment recommendations worldwide. The evidence evaluation process for these guide- During the evidence evaluation process the ILCOR task lines was built on the international efforts that produced the ECC Guidelines 2000.2 rces weighed the evidence and developed consensus state To begin the process, ILCOR representatives established 6 ments on the interpretation of the scientific findings. If the task forces agreed on common treatment recommendations ask forces: basic life support, advanced life support, acute the recommendations were included with the science state coronary syndromes, pediatric life support, neonatal life support,and an interdisciplinary task force to address over. ments in the ILCOR 2005 CPR Consensus. 'The consensu ping topics such as education. The AHA established 2 document was designed to serve as the science foundation for additional task forces-on stroke and first aid the 8 task the guidelines to be ed by many ILCOR councils in 2005-2006 forces identified topics requiring evidence evaluation. They rces Classes of Recommendation appointed international experts as worksheet authors for each Following the 2005 Consensus Conference, AHA ECC ex thesis. The worksheet authors were asked to (1) search for and perts adapted the ILCOR scientific statements and expanded the treatment recommendations to construct these new guide- ritically evaluate evidence on the hypothesis,(2)summarize lines. In developing these guidelines, the ECC experts used a recommendation classification system that is consistent with ( Circulation. 2005: 112: IV-1-IV-5) that used by the American Heart Association-American o 2005 American Heart Association College of Cardiology collaboration on evidence-based This special supplement to Circulation is freely available at http://www.circulationaha.org The classes of recommendation used in this document are DOI: 10.1161/CIRCULATIONAHA 105. 166550 listed in Table 3. These classes represent the integration of the ⅣVIPart 1: Introduction This publication presents the 2005 American Heart Asso￾ciation (AHA) guidelines for cardiopulmonary resusci￾tation (CPR) and emergency cardiovascular care (ECC). The guidelines are based on the evidence evaluation from the 2005 International Consensus Conference on Cardiopulmo￾nary Resuscitation and Emergency Cardiovascular Care Sci￾ence With Treatment Recommendations, hosted by the Amer￾ican Heart Association in Dallas, Texas, January 23–30, 2005.1 These guidelines supersede the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovas￾cular Care. 2 As with all versions of the ECC guidelines published since 1974,2– 6 the 2005 AHA Guidelines for CPR and ECC contain recommendations designed to improve survival from sudden cardiac arrest and acute life-threatening cardiopulmonary problems. These guidelines, however, differ from previous versions in several ways. First, they are based on the most extensive evidence review of CPR yet published.1 Second, these guidelines were developed under a new structured and transparent process for ongoing disclosure and management of potential conflicts of interest. Third, the guidelines have been streamlined to reduce the amount of information that rescuers need to learn and remember and to clarify the most important skills that rescuers need to perform. Evidence Evaluation Process The evidence evaluation process that was the basis for these guidelines was accomplished in collaboration with the Inter￾national Liaison Committee on Resuscitation (ILCOR),1 an international consortium of representatives from many of the world’s resuscitation councils. ILCOR was formed to system￾atically review resuscitation science and develop an evidence-based consensus to guide resuscitation practice worldwide. The evidence evaluation process for these guide￾lines was built on the international efforts that produced the ECC Guidelines 2000.2 To begin the process, ILCOR representatives established 6 task forces: basic life support, advanced life support, acute coronary syndromes, pediatric life support, neonatal life support, and an interdisciplinary task force to address over￾lapping topics such as education. The AHA established 2 additional task forces— on stroke and first aid. The 8 task forces identified topics requiring evidence evaluation. They formulated hypotheses on these topics, and the task forces appointed international experts as worksheet authors for each hypothesis. The worksheet authors were asked to (1) search for and critically evaluate evidence on the hypothesis, (2) summarize the evidence review, and (3) draft treatment recommenda￾tions. They then completed worksheets that provided the format for a structured literature review (Table 1). The worksheet authors identified key research studies, recorded the levels of evidence (Table 2) of the studies, and drafted recommendations. When possible, two worksheet authors, one from the United States and one from outside the United States, were recruited to complete independent reviews of each topic. This process is described in detail in the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treat￾ment Recommendations1 and the accompanying editorial.7 A total of 281 worksheet authors completed 403 work￾sheets on 276 topics. To obtain feedback from the resuscita￾tion science community, in December 2004 the worksheets and worksheet author conflict of interest disclosures were posted on the Internet at http://www.C2005.org. Journal advertisements and emails invited comment from healthcare professionals and the resuscitation community. The com￾ments were then referred to the task forces and worksheet authors for consideration. Worksheets are available through http://www.C2005.org. Expert reviews began in 2002, and individual topics were presented and discussed at 6 international meetings, culmi￾nating in the 2005 Consensus Conference. The evidence was presented, discussed, and debated, with task forces and resuscitation councils meeting daily to draft summaries. The consensus statements on the science of resuscitation devel￾oped at the conference were incorporated into the ILCOR 2005 CPR Consensus, published simultaneously in Circula￾tion and Resuscitation in November 2005.1 Guidelines and Treatment Recommendations During the evidence evaluation process the ILCOR task forces weighed the evidence and developed consensus state￾ments on the interpretation of the scientific findings. If the task forces agreed on common treatment recommendations, the recommendations were included with the science state￾ments in the ILCOR 2005 CPR Consensus. 1 The consensus document was designed to serve as the science foundation for the guidelines to be published by many ILCOR member councils in 2005–2006. Classes of Recommendation Following the 2005 Consensus Conference, AHA ECC ex￾perts adapted the ILCOR scientific statements and expanded the treatment recommendations to construct these new guide￾lines. In developing these guidelines, the ECC experts used a recommendation classification system that is consistent with that used by the American Heart Association–American College of Cardiology collaboration on evidence-based guidelines. The classes of recommendation used in this document are listed in Table 3. These classes represent the integration of the (Circulation. 2005;112:IV-1-IV-5.) © 2005 American Heart Association. This special supplement to Circulation is freely available at http://www.circulationaha.org DOI: 10.1161/CIRCULATIONAHA.105.166550 IV-1