Cardiopulmonary resuscitation update.
10.5124/jkma.2013.56.7.600
- Author:
Sung Oh HWANG
1
Author Information
1. Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. shwang@yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Cardiopulmonary resuscitation;
Heart arrest
- MeSH:
Cardiopulmonary Resuscitation;
Collodion;
Death, Sudden, Cardiac;
Developed Countries;
Emergencies;
Epinephrine;
Glucose;
Heart Arrest;
Humans;
Hypogonadism;
Hypothermia;
Korea;
Mitochondrial Diseases;
Ophthalmoplegia;
Out-of-Hospital Cardiac Arrest;
Oxygen;
Percutaneous Coronary Intervention;
Thorax;
Ventilation
- From:Journal of the Korean Medical Association
2013;56(7):600-608
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Sudden cardiac arrest is a growing medical issue in developed countries. Annually, more than 25,000 out-of-hospital cardiac arrests (OHCA) occur in Korea. Only 3% of victims with OHCA discharge alive from hospital and less than 1% of them survive neurologically intact. Major changes of recent guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care includes modification of basic life support (BLS) sequence from A-B-C to C-A-B, an emphasis on minimally interrupted, high-quality chest compression, the introduction of chest compression-only CPR, and addition of integrated post-cardiac arrest care concept as the fifth chain in the Chain of Survival. Repetition of 2-minutes of CPR, rhythm check, and defibrillation if indicated is recommended as a universal algorithm during BLS. Defibrillation and drug administration including epinephrine should not be delayed to place an advanced airway during CPR. Important interventions during post-cardiac arrest care are comprised of the optimization of ventilation (arterial CO2 tension, 40 to 45 mmHg) and oxygenation (arterial O2 saturation, 94% to 98%), glucose control (blood glucose, 144 to 180 mg/dL), therapeutic hypothermia (body tem-perature, 32degrees C to 34degrees C) for unresponsive patients, and percutaneous coronary intervention for the patient with ST-segment elevation. Systemic approaches to increase public awareness of cardiac arrest and CPR, to spread CPR education to citizen, and to implement public access defibrillation are a prerequisite for improving survival from OHCA in the community. Effective advanced life support and integrated post-cardiac arrest care should be provided to increase neurologically intact survival among the patients resuscitated from cardiac arrest.
