Update on cardiopulmonary resuscitation.
Adult cardiopulmonary resuscitation (CPR) has been shown to improve survival for individuals suffering cardiac arrest. Despite this, the delivery of basic life support to victims outside the clinical environment remains poor, particularly as only a minority receive resuscitation. In addition, research continues to examine the optimal techniques for CPR and guidelines have been modified to reflect the latest developments. These guidelines are a compromise between simplicity and effectiveness. While the core of the guidelines remains unchanged, the latest recommendations focus on minimising any delay in the assessment of the collapsed patient and the initiation of CPR. They also address the recent body of opinion promoting compression-only CPR as an alternative to the combined technique of compression and mouth-to-mouth ventilation. Throughout the guidelines a more pragmatic approach to resuscitation is adopted to try to encourage all individuals, whether trained healthcare professionals or lay people, to initiate resuscitation. An acknowledgement of the reasons why individuals may be reluctant to start resuscitation through fear or anxiety will hopefully help to encourage the instigation of these techniques. This overview will summarise the guidelines and highlight alterations or alternatives where appropriate.
Department of Cardiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB252ZN, UK. richardgood@nhs.net
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D000328:Adult; D000465:Algorithms; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods*; D004554:Electric Countershock; D005060:Europe; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial; D013124:Spinal Injuries / Q000209:etiology