title: Update on cardiopulmonary resuscitation guidelines of interest to anesthesiologists.
abstract: OBJECTIVE
  The new cardiopulmonary resuscitation (CPR) guidelines emphasize the importance of high-quality chest compressions and modify some routines. The objective of this report was to review the main changes in resuscitation practiced by anesthesiologists.
  
  
  BACKGROUND
  The emphasis on high-quality chest compressions with adequate rate and depth allowing full recoil of the chest and with minimal interruptions is highlighted in this update. One should not take more than ten seconds checking the pulse before starting CPR. The universal relationship of 30:2 is maintained, modifying its order, initiating with chest compressions, followed by airways and breathing (C-A-B instead of A-B-C). The procedure "look, listen, and feel whether the patient is breathing" was removed from the algorithm, and the use of cricoid pressure during ventilations is not recommended any more. The rate of chest compressions was changed for at least one hundred per minute instead of approximately one hundred per minute, and its depth in adults was changed to 5 cm instead of the prior recommendation of 4 to 5 cm. The single shock is maintained, and it should be of 120 to 200 J when it is biphasic; and 360 J when it is monophasic. In advanced cardiac life support, the use of capnography and capnometry to confirm intubation and monitoring the quality of CPR is a formal recommendation. Atropine is no longer recommended for routine use in the treatment of pulseless electrical activity or asystole.
  
  
  CONCLUSIONS
  Updating the phases of the new CPR guidelines is important, and continuous learning is recommended. This will improve the quality of resuscitation and survival of patients in cardiac arrest.
authors.affiliation: Pain and Intensive Care Medicine Discipline of the Universidade Federal de São Paulo-Escola Paulista de Medicina, Brazil. luizfernandofalcao@gmail.com
authors.forename: Luiz Fernando dos Reis
authors.initials: LF
authors.lastname: Falcão
authors.forename: David
authors.initials: D
authors.lastname: Ferez
authors.forename: José Luiz Gomes
authors.initials: JL
authors.lastname: do Amaral
mesh_terms: D022561:Advanced Cardiac Life Support / Q000592:standards; D000465:Algorithms; D000776:Anesthesiology; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D006801:Humans; D008991:Monitoring, Physiologic; D017410:Practice Guidelines as Topic