Cardiac arrest and the 2010 advanced cardiac life support guidelines--part IV

The chance of a successful outcome with any cardiac arrest is prompt initiation of hands-only compression at a rate of at least 100 per min, to a depth of 2 in.,with full chest recoil, and no more than a 10-s interruption of compressions. The priority, regardless of being in a private clinic or in a facility using a team approach,is to start compressions and maintain effective compressions with minimal interruptions. Most cardiac arrests are related to ventricular fibrillation and the chance of successfully defibrillating this rhythm is highest at the beginning of the arrest. For every minute a patient is in ventricular fibrillation, his or her chance of survival greatly decreases (Traverset al., 2010). This is why it is extremely important to defibrillate immediately. Once a patient has return of spontaneous circulation,postresuscitation care needs to be implemented. The biggest reason for a patient to develop ventricular fibrillation is an acute coronary syndrome, and this is why the new guidelines have outlined transferring a post arrest patient to a cardiac catheterization laboratory to perform an emergency angiogram and angioplasty. Part of this post arrest management also includes therapeutic hypothermia in those patients who remain comatose after return of spontaneous circulation. This article has reviewed a case study of a postoperative patient who developed ventricular fibrillation and the priorities of care according to the 2010 ACLS guidelines. Watch for more ACLS-based case studies in upcoming articles.