Adult Resuscitation Review and Update

Benjamin Wachira

Overview• Introduction

• Major changes in the 2005 AHA Guidelines for CPR and ECC video

• Summary

Introduction• The 2005 AHA Guidelines for CPR and

ECC are based on the most comprehensive review of resuscitation literature ever published.

Introduction (cont…)

• The evidence evaluation process incorporated the input of 381 international resuscitation experts who evaluated research topics, and hypotheses over a 36-month period before the 2005 Consensus Conference.

Major changes in the 2005 AHA Guidelines for CPR and ECC video

• Disclaimer:

This video is not a replacement for the information contained in the 2005 AHA Guidelines for CPR and ECC.

Adult CPR update video

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Questions

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Summary• No human data has identified the optimal

compression-ventilation ratio for CPR for victims of all ages

Summary (cont…)

• No studies in humans or animals has specifically compared the 1-shock defib strategy with the 3-stacked-shock sequence

• Biphasic Defibs have a ±90% 1st shock efficacy and if 1 shock fails to eliminate VF, the VF may be of low amplitude and the incremental benefit of another shock is low, CPR is more beneficial.

Summary (cont…)

• Almost all patients have a non perfusing rhythm for a period of time after successful shock. One study found that 80% were in PEA/asystole and 20% remained in VF

Summary (cont…)

• Despite the widespread use of epinephrine and several studies of vasopressin, no placebo-controlled study has shown that any medication or vasopressor given routinely at any stage during cardiac arrest increases rate of survival to hospital discharge

References• AHA ACLS Resource Text