MONDAY, Oct. 26, 2020 — The importance of cardiopulmonary resuscitation (CPR) is reaffirmed in an updated American Heart Association guideline published as a supplement to the Oct. 20 issue of Circulation.
Raina M. Merchant, M.D., from the University of Pennsylvania, and colleagues conducted an extensive evidence evaluation to develop guidelines for CPR and emergency cardiovascular care.
The authors reaffirm the importance of CPR and recommend that lay rescuers initiate CPR for presumed cardiac arrest due to a low risk for harm for patients not in cardiac arrest. Early defibrillation is critical to survival along with CPR when sudden cardiac arrest is caused by ventricular fibrillation or pulseless ventricular tachycardia. The usefulness of double sequential defibrillation has not been established for refractory shockable rhythm. Individualized management of resuscitation is emphasized; for example, new algorithms are provided for opioid-associated emergencies. Activation of emergency response systems should not be delayed while awaiting patient response to naloxone. Oxygenation and airway management should be prioritized during resuscitation from cardiac arrest in pregnancy as pregnant patients are more prone to hypoxia. An additional link (recovery) has been added to the chain of survival. Aspects of recovery include structured assessment for anxiety, depression, posttraumatic stress, and fatigue for cardiac arrest survivors and their caregivers; multimodal rehabilitation assessment and treatment; and comprehensive multidisciplinary discharge planning.
“High-quality CPR can make the difference between who lives and who dies from cardiac arrest and dedicated funding and efforts are needed to ensure that everyone who needs high-quality CPR receives it,” Merchant said in a statement.
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