Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Part I Introduction
- Part II Basic science
- Part III The pathophysiology of global ischemia and reperfusion
- Part IV Therapy of sudden death
- 23 Prevention of sudden cardiac death
- 24 Sequence of therapies during resuscitation: application of CPR
- 25 Transthoracic defibrillation
- 26 Automated external defibrillators
- 27 Public access defibrillation
- 28 The physiology of ventilation during cardiac arrest and other low blood flow states
- 29 Airway techniques and airway devices
- 30 Manual cardiopulmonary resuscitation techniques
- 31 Mechanical devices for cardiopulmonary resuscitation
- 32 Invasive reperfusion techniques
- 33 Routes of drug administration
- 34 Adrenergic agonists
- 35 Vasopressin and other non-adrenergic vasopressors
- 36 Antiarrhythmic therapy during cardiac arrest and resuscitation
- 37 Acid–base considerations and buffer therapy
- 38 Cardiac arrest resuscitation monitoring
- 39 Special considerations in the therapy of non-fibrillatory cardiac arrest
- 40 Cardiocerebral resuscitation: a new approach to out-of-hospital cardiac arrest
- 41 Thrombolysis during resuscitation from cardiac arrest
- 42 Percutaneous coronary intervention (PCI) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation
- 43 Emergency medical services systems and out-of-hospital cardiac arrest
- 44 In-hospital resuscitation
- 45 Complications of CPR
- 46 Bringing it all together: state-of-the-art therapy for cardiac arrest
- Part V Postresuscitation disease and its care
- Part VI Special resuscitation circumstances
- Part VII Special issues in resuscitation
- Index
40 - Cardiocerebral resuscitation: a new approach to out-of-hospital cardiac arrest
from Part IV - Therapy of sudden death
Published online by Cambridge University Press: 06 January 2010
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Part I Introduction
- Part II Basic science
- Part III The pathophysiology of global ischemia and reperfusion
- Part IV Therapy of sudden death
- 23 Prevention of sudden cardiac death
- 24 Sequence of therapies during resuscitation: application of CPR
- 25 Transthoracic defibrillation
- 26 Automated external defibrillators
- 27 Public access defibrillation
- 28 The physiology of ventilation during cardiac arrest and other low blood flow states
- 29 Airway techniques and airway devices
- 30 Manual cardiopulmonary resuscitation techniques
- 31 Mechanical devices for cardiopulmonary resuscitation
- 32 Invasive reperfusion techniques
- 33 Routes of drug administration
- 34 Adrenergic agonists
- 35 Vasopressin and other non-adrenergic vasopressors
- 36 Antiarrhythmic therapy during cardiac arrest and resuscitation
- 37 Acid–base considerations and buffer therapy
- 38 Cardiac arrest resuscitation monitoring
- 39 Special considerations in the therapy of non-fibrillatory cardiac arrest
- 40 Cardiocerebral resuscitation: a new approach to out-of-hospital cardiac arrest
- 41 Thrombolysis during resuscitation from cardiac arrest
- 42 Percutaneous coronary intervention (PCI) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation
- 43 Emergency medical services systems and out-of-hospital cardiac arrest
- 44 In-hospital resuscitation
- 45 Complications of CPR
- 46 Bringing it all together: state-of-the-art therapy for cardiac arrest
- Part V Postresuscitation disease and its care
- Part VI Special resuscitation circumstances
- Part VII Special issues in resuscitation
- Index
Summary
Introduction
Prehospital treatment of cardiac arrest became practical in 1960 when the technique of closed chest cardiac massage was demonstrated effectively to prolong the time for successful defibrillation following cessation of circulation due to cardiac arrest. Closed chest massage was merged with externally applied defibrillation and mouth-to-mouth ventilation to form what is today known as cardiopulmonary resuscitation or CPR. By 1966 standardized training and performance criteria had been developed and published. A few years later the American Heart Association (AHA) adopted CPR and spearheaded the campaign to disseminate it to both professionals and the public. The AHA periodically reviews the science, practice and implementation of CPR and publishes updated “guidelines.”
As an organizational model, CPR can be considered an outstanding public health achievement; but its success in this realm is marred by its failure as a treatment modality for patients who sustain an out-of-hospital cardiac arrest (OOH-CA). When the currently recommended guidelinedriven CPR is used to treat patients with an OOH-CA, survival rates have been and continue to be dismal. These poor and unchanged survival rates, in spite of periodic updates, may in part be explained because CPR was conceived as and is currently promulgated as an appropriate intervention for what turns out to be two pathophysiologically entirely different disorders: respiratory arrest and cardiac arrest.
A new approach to the resuscitation of individuals with out-of-hospital cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia was developed by the University of Arizona Sarver Heart Center CPR Research Group in Tucson, Arizona.
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- Chapter
- Information
- Cardiac ArrestThe Science and Practice of Resuscitation Medicine, pp. 747 - 756Publisher: Cambridge University PressPrint publication year: 2007