Management of Cardiac Arrest: A Discussion of Cardiorespiratory Resuscitation

In cases of sudden cardiac arrest the time limit during which anoxic brain damage can be reversed is about four minutes. Therefore, cardiorespiratory resuscitation must be instituted immediately. A simple plan requiring no complicated maneuvers or equipment should be memorized and employed in such cases. The following program is recommended: (1) Institute artificial ventilation. (2) Thump the chest once or twice. (3) Employ closed chest compression. (4) Transfer the patient to hospital if survival appears possible. (5) Obtain an electrocardiogram immediately. (6) Apply specific treatment for cardiac standstill or ventricular fibrillation. (7) Reassess after 30 minutes. Discontinue treatment if there has been no response; if the pupils have remained dilated, fixed and unresponsive to light for over 10 minutes; or if it has been ascertained that the patient has definite serious illness incompatible with continuing life. Such a plan as outlined above should be instituted at once, before attempting to determine the cause of cardiac arrest or planning further special treatment.