Editorials

Drugs for resuscitation after cardiac arrest

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c1877 (Published 09 April 2010) Cite this as: BMJ 2010;340:c1877
  1. Benjamin S Abella, clinical research director
  1. 1Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA 19003, USA
  1. benjamin.abella{at}uphs.upenn.edu

    CPR and defibrillation are higher priorities

    Sudden cardiac arrest, in which cardiac output abruptly ceases, is one of the most time sensitive disease processes in medicine. When a lethal cardiac arrhythmia results in the cessation of blood flow, mortality increases about 5-10% for every minute without treatment.1

    This year is the 50th anniversary of modern cardiopulmonary resuscitation (CPR).2 The current approach to sudden cardiac arrest involves the “chain of survival” paradigm,3 a stepwise set of actions that includes prompt recognition of arrest and notification of the emergency medical system, immediate delivery of CPR, electrical defibrillation if appropriate, and rapid delivery of the patient to healthcare professionals who can administer advanced cardiac life support. Advanced cardiac life support involves the use of airway adjuncts, ventilation with supplemental oxygen, and the administration of drugs such as adrenaline, atropine, or amiodarone.

    Cohort studies suggest that immediate CPR doubles the likelihood of survival to hospital discharge compared with delaying CPR until the arrival of trained rescuers.4 CPR is highly accessible—it can be administered by laypeople and healthcare professionals. People can …

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