title: Update on cardiopulmonary resuscitation and emergency cardiovascular care guidelines.
abstract: OBJECTIVE
  The key changes included in the 2005 cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) guidelines are reviewed. Advances since publication of the current guidelines are also discussed.
  
  
  CONCLUSIONS
  The 2005 CPR and ECC guidelines include several key changes from the previous version published in 2000. The new guidelines place an increased emphasis on chest compressions and recommend a compression:ventilation (C:V) ratio of 30:2. Current knowledge on defibrillation has also been incorporated by recommending that Emergency Medical Service (EMS) rescuers give two minutes of CPR before defibrillation when the response interval is greater than four to five minutes and EMS responders did not witness the arrest. Another major change is the recommendation for a single shock to be administered followed immediately by CPR with no check of the cardiac rhythm until two minutes of CPR has been performed postdefibrillation. The 2005 guidelines recommend that an automated external defibrillator should be implemented in public locations where there is a relatively high likelihood of witnessed cardiac arrest. In addition, the most recent guidelines highlight the shift from primary-rhythm-based therapies and resuscitation to a focus on neurologic outcomes.
  
  
  CONCLUSIONS
  Several evidence-based changes were included in the 2005 CPR and ECC guidelines, including a C:V ratio of 30:2 and mitigation of hands-off time, early defibrillation, administration of a single shock versus a three-shock sequence, use of public-access defibrillators, and a shift from primary-rhythm-based therapies to a focus on neurologic outcomes.
authors.affiliation: Department of Pharmacy, and Pharmacotherapeutic Specialist-Emergency Medicine, Queen Elizabeth II Health Sciences Centre (QEIIHSC), Halifax, NS, Canada. peter.zed@dal.ca
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Zed
authors.forename: Riyad B
authors.initials: RB
authors.lastname: Abu-Laban
authors.forename: Michael
authors.initials: M
authors.lastname: Shuster
authors.forename: Robert S
authors.initials: RS
authors.lastname: Green
authors.forename: Richard S
authors.initials: RS
authors.lastname: Slavik
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Travers
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards*; D002318:Cardiovascular Diseases / Q000628:therapy*; D003131:Combined Modality Therapy; D047548:Defibrillators; D004554:Electric Countershock / Q000379:methods; D004632:Emergency Medical Services / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D000889:Anti-Arrhythmia Agents