Monday, June 15, 2009

In case you need a refresher on CPR and ACLS

---here’s yet another review. This Medscape linked full text article discusses the 2005 guidelines, the evidentiary and basic science rationale behind them and some research reported since publication of the guidelines. Emerging evidence is suggesting that compression only resuscitation may be superior to compression-ventilation resuscitation for many types of cardiac arrest.

Should CPR be done before defibrillation? In an unwitnessed arrest, absolutely. For a witnessed arrest it depends on the immediacy with which defibrillation can be applied. The review discussed the rationale and related controversies.

Therapeutic hypothermia is discussed. Despite substantial evidence in favor of applied hypothermia post cardiac arrest the uptake of this evidence is low. The article notes:

Despite this evidence, studies have found that the majority of physicians have not used induced hypothermia in the management of cardiac arrest survivors. Future studies are required to investigate the barriers and solution to instituting induced hypothermia.

Here’s my not so humble opinion on what the barriers are.

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