Ashish Panchel, Jason Bartos, Jose Cabanas et el published uptdated guidelines for cardiac resuscitation in Circulation.
Salient features are summarized in this picture.
Now a days the guidelines are updated on a continuous basis but these are the salient changes summarized in a table form.
| Most updated treatment recommendations for cardiac arrest resuscitation | ||
| FOR | AGAINST | |
| AIRWAY MANAGEMENT |
Bag-mask valve or an advanced Airway.
|
Cricoid pressure |
| MECHANICAL CPR | Where sustained high-quality manual chest compressions are impractical or compromise provider safety | ROUTINE USE not recommended |
| IV OR IO | IV | IO ONLY IF CANT GET IV |
| VASOPRESSORS |
EPINEPHRINE FOR nonshockable rhythms, as soon as feasible FOR SHOCKABLE RHYTHM, after initial attempts of shock fail |
Vasopressin, alone or with epinephrine |
| ANTIARRHYTHMIC MEDICATIONS |
Amiodarone or lidocaine in adults with shock-refractory ventricular fibrillation/ pulseless ventricular tachycardia | Routine use of magnesium not recommended. May be considered for treatment of polymorphic VT associated with a long QT interval (torsades de pointes) |
| HEMODYNAMICS-GUIDED RESUSCITATION |
Against using ETCO2 cutoff values alone as a mortality predictor or on the decision to stop a resuscitation attempt | |
| DOUBLE SEQUENTIAL DEFIBRILLATION | Not proven yet | |
| EXTRACORPOREAL CPR | Routine use not recommended | |
| POINT-OF-CARE ULTRASOUND | Not beneficial | |
| POST RESUSCITATIVE CARE | Comprehensive, structured, multidisciplinary system of care should be implemented |
|
| RECOVERY AND SURVIVORSHIP |
Address treatment, surveillance, |
|
| BOOSTER TRAINING FOR PROVIDERS |
Every 2 yrs |
|
A new phase of recovery is added to the chain of survival links.
