In December 2005 the Resuscitation Council (UK) published revised guidelines and treatment algorithms following widespread research and debate at international conferences. These were the first changes for five years. The most noticeable change for adult resuscitation in basic and advanced life support is an increase in the ratio of compressions to ventilations of 30:2. Other noticeable changes in advanced life support are the delivery of only one shock at 360 J monophasic or 150-360 J biphasic if the patient is in a shockable rhythm and a period of two minutes cardiopulmonary resuscitation until each pulse check, regardless of the rhythm.

On a recent skiing holiday in a major Alpine resort, one of the authors was about to leave the slopes for the day to embark on some après ski when a friend came running to her and said, “A man has collapsed.” She went round the corner and found an unconscious man with his wife who was just commencing mouth to mouth resuscitation. The author was then joined by two German nurses, one British paediatric nurse, one French dentist, and a British nursing student.

As the most experienced medical professional, the author led this ad hoc international cardiac arrest team. The French dentist provided some airway …