Disclaimer: This article is purely for information purposes only. It is intended for healthcare professionals only and not for patients. The information below is not a substitute for a doctor’s/physician’s visit.

An review article published in Emergency Medicine Clinics of North America Journal in July 2020 which shows recent updates of cardiac arrest resuscitation protocol.

Abstract:

 

There are approximately 350,000 out-of-hospital cardiac arrests and 200,000 in-hospital cardiac arrests annually in the United States, with survival rates of approximately 5% to 10% and 24%, respectively. The critical factors that have an impact on cardiac arrest survival include prompt recognition and activation of pre-hospital care, early cardiopulmonary resuscitation, and rapid defibrillation. Advanced life support protocols are continually refined to optimize intra-cardiac arrest management and improve survival with favorable neurologic outcome. This article focuses on current treatment recommendations for adult non-traumatic cardiac arrest, with emphasis on the latest evidence and controversies regarding intra-cardiac arrest management.

 

Summary – Nine critical actions during cardiac arrest according to priority.

1. Initiate and maintain high-quality chest compressions. Consider using a mechanical CPR device if manual CPR cannot be performed optimally.

2. Achieve early defibrillation for shockable rhythm.

3. Use bag-valve mask or establish advanced airway. A supraglottic airway may be used in settings with low rate of success for endotracheal intubation.

4. Monitor waveform capnography with goal end-tidal CO2>20 mm Hg.

5. Obtain IV access for drug administration. IO access can be used as alternative if IV access cannot be obtained.

6. Administer epinephrine as soon as feasible for nonshockable rhythm and after unsuccessful defibrillation attempts for shockable rhythm.

7. Consider amiodarone or lidocaine administration for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.

8. Establish an arterial line for hemodynamic-guided resuscitation with goal arterial diastolic pressure >30–35 mm Hg.

9. Perform point-of-care echocardiography only if it does not delay other resuscitative efforts.

Read the review paper for more in detail here – https://www.sciencedirect.com/science/article/abs/pii/S0733862720300596

Helpful Link – The AHA provides a Web-based living document of its most recent guidelines at its CPR and emergency cardiovascular care guidelines Web site https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines

Source Reference:

Lam, Vivian, and Cindy H Hsu. “Updates in Cardiac Arrest Resuscitation.” Emergency medicine clinics of North America vol. 38,4 (2020): 755-769. doi:10.1016/j.emc.2020.06.003