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Ewy GA. Cardiocerebral and cardiopulmonary resuscitation - 2017 update. Acute Med Surg. 2017;4(3):227-234doi: 10.1002/ams2.281.
Ewy, G. A. (2017). Cardiocerebral and cardiopulmonary resuscitation - 2017 update. Acute medicine & surgery, 4(3), 227-234. https://doi.org/10.1002/ams2.281
Ewy, Gordon A. "Cardiocerebral and cardiopulmonary resuscitation - 2017 update." Acute medicine & surgery vol. 4,3 (2017): 227-234. doi: https://doi.org/10.1002/ams2.281
Ewy GA. Cardiocerebral and cardiopulmonary resuscitation - 2017 update. Acute Med Surg. 2017 May 26;4(3):227-234. doi: 10.1002/ams2.281. eCollection 2017 Jul. PMID: 29123868; PMCID: PMC5674458.
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Acute Med Surg. 2017 May 26;4(3):227-234. doi: 10.1002/ams2.281. eCollection 2017 Jul.

Cardiocerebral and cardiopulmonary resuscitation - 2017 update.

Acute medicine & surgery

Gordon A Ewy

Affiliations

  1. Department of Medicine (Cardiology) University of Arizona College of Medicine Tucson AZ USA.

PMID: 29123868 PMCID: PMC5674458 DOI: 10.1002/ams2.281

Abstract

Sudden cardiac arrest is a major public health problem in the industrialized nations of the world. Yet, in spite of recurrent updates of the guidelines for cardiopulmonary resuscitation and emergency cardiac care, many areas have suboptimal survival rates. Cardiocerebral resuscitation, a non-guidelines approach to therapy of primary cardiac arrest based on our animal research, was instituted in Tucson (AZ, USA) in 2002 and subsequently adopted in other areas of the USA. Survival rates of patients with primary cardiac arrest and a shockable rhythm significantly improved wherever it was adopted. Cardiocerebral resuscitation has three components: the community, the pre-hospital, and the hospital. The community component emphasizes bystander recognition and chest compression only resuscitation. Its pre-hospital or emergency medical services component emphasizes: (i) urgent initiation of 200 uninterrupted chest compressions before and after each indicated single defibrillation shock, (ii) delayed endotracheal intubation in favor of passive delivery of oxygen by a non-rebreather mask, (iii) early adrenaline administration. The hospital component was added later. The national and international guidelines for cardiopulmonary resuscitation and emergency medical services are still not optimal, for several reasons, including the fact that they continue to recommend the same approach for two entirely different etiologies of cardiac arrest: primary cardiac arrest, often caused by ventricular fibrillation, where the arterial blood oxygenation is little changed at the time of the arrest, and secondary cardiac arrest from severe respiratory insufficiency, where the arterial blood is severely desaturated at the time of cardiac arrest. These different etiologies need different approaches to therapy.

Keywords: Bystander CPR; out‐of‐hospital cardiac arrest; primary cardiac arrest; respiratory arrest

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