AANA journal course: update for nurse anesthetists--current concepts in cardiopulmonary resuscitation

Developmental strides in cardiopulmonary resuscitation were paralleled by acquired knowledge of pulmonary and cardiac physiology. The evolution of the current recommendations for cardiopulmonary resuscitation have evolved over the past 40 years as a result of human trial and error and have been authenticated through laboratory research and clinical experience. Current research efforts in cardiopulmonary resuscitation are examining the mechanisms of blood flow during external cardiac massage and techniques to optimize myocardial and cerebral perfusion during the resuscitative period. The restoration of circulation with preservation of myocardial and neurological function is the essential goal during the resuscitative effort. Prior to the 1950s, the occurrence of cardiac arrest was associated with the conduct of anesthesia and surgery. Although infrequent today by comparison, cardiac arrest continues to occur with the conduct of regional and general anesthesia. This course will review the etiology of cardiac arrest during anesthesia, detail the mechanisms of blood flow during resuscitation, and review the pharmacological importance of epinephrine for the preservation of myocardial and neurologic function.