Cardiopulmonary resuscitation and management of cardiac arrest.
The best chance of survival with a good neurological outcome after cardiac arrest is                 afforded by early recognition and high-quality cardiopulmonary resuscitation (CPR),                 early defibrillation of ventricular fibrillation (VF), and subsequent care in a                 specialist center. Compression-only CPR should be used by responders who are unable                 or unwilling to perform mouth-to-mouth ventilations. After the first defibrillator                 shock, further rhythm checks and defibrillation attempts should be performed after 2                 min of CPR. The underlying cause of cardiac arrest can be identified and treated                 during CPR. Drugs have a limited effect on long-term outcomes after cardiac arrest,                 although epinephrine improves the success of resuscitation, and amiodarone increases                 the success of defibrillation for refractory VF. Supraglottic airway devices are an                 alternative to tracheal intubation, which should be attempted only by skilled                 rescuers. Care after cardiac arrest includes controlled reoxygenation, therapeutic                 hypothermia for comatose survivors, percutaneous coronary intervention, circulatory                 support, and control of blood-glucose levels and seizures. Prognostication in                 comatose survivors of cardiac arrest needs a careful, multimodal approach using                 clinical and electrophysiological assessments after at least 72 h.
Anaesthesia and Intensive Care Medicine, Royal United                     Hospital, Combe Park, Bath                 BA1 3NG, UK.
Jerry P
JP
Nolan
Jasmeet
J
Soar
Volker
V
Wenzel
Peter
P
Paal
D058109:Airway Management / Q000379:methods; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D047548:Defibrillators; D004837:Epinephrine / Q000627:therapeutic use; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D013566:Sympathomimetics / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014667:Vasopressins / Q000627:therapeutic use; D014693:Ventricular Fibrillation / Q000628:therapy*
D000889:Anti-Arrhythmia Agents; D013566:Sympathomimetics; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D004837:Epinephrine