Narrative Review: Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: Review of the Current Guidelines

7 August 2007 | Volume 147 Issue 3 | Pages 171-179

Sudden cardiac death is a major clinical problem, causing 300 000 to 400 000 deaths annually and 63% of all cardiac deaths. Despite the overall decrease in cardiovascular mortality, the proportion of cardiovascular death from sudden cardiac death has remained constant. Survival rates among patients who have out-of-hospital cardiac arrest vary from 5% to 18%, depending on the presenting rhythm.

The latest guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care published by the American Heart Association include substantial changes to the algorithms for basic life support and advanced cardiovascular life support. For unwitnessed cardiac arrest, immediate defibrillation of the patient is no longer recommended. Rather, 2 minutes of CPR before defibrillation is now recommended. People in cardiac arrest should no longer receive stacked shocks. The compression–ventilation ratio has been changed from 15:2 to 30:2.

This article is a contemporary review of the management of CPR and emergency cardiovascular care. It examines current practice and data supporting use of CPR, along with changes in the management of sudden cardiac death.

Author and Article Information

From Atlanta Veterans Affairs Medical Center, Decatur, Georgia, and Emory University School of Medicine, Atlanta, Georgia.

Acknowledgments: The authors thank the members of the Cardiopulmonary Resuscitation Committee of the Atlanta Veterans Affairs Medical Center.

Grant Support: By National Institutes of Health grant 1U01HL079156.

Potential Financial Conflicts of Interest: Grants received: A.M. Zafari (Cardiac Science).

Requests for Single Reprints: A. Maziar Zafari, MD, PhD, Division of Cardiology, Emory University, Woodruff Memorial Research Building, Room 322, 1639 Pierce Drive, Atlanta, GA 30322; e-mail, azafari{at}emory.edu.

Current Author Addresses: Dr. Ali: Veterans Affairs Medical Center Atlanta, Room 4A-168, 1670 Clairmont Road, Decatur, GA 30033.

Dr. Zafari: Division of Cardiology, Emory University, Woodruff Memorial Research Building, Room 322, 1639 Pierce Drive, Atlanta, GA 30322.

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