[Update on cardiopulmonary resuscitation: what changed with the new guidelines]

New resuscitation guidelines contain significant changes intended to improve resuscitation practice and survival from cardiac arrest. This article provides an overview of the key changes on resuscitation for healthcare provider.

There are several new recommendations on cardiopulmonary resuscitation (CPR), the major are intended to provide good circulation during cardiac arrest. The most important change is the emphasis on high-quality chest compressions with minimal interruptions. The universal 30:2 ratio is recommended to simplify training, to achieve optimal compression rates and to reduce the frequency of interruptions. Only one shock is delivered when indicated, followed immediately by CPR. This shock should be of 120-200J on a biphasic wave or 360J on a monophasic wave. Rescuers should not interrupt chest compressions to check rhythm until after about 5 cycles or approximately 2 minutes of CPR. After this period, if an organized rhythm is present, the healthcare provider should check for a pulse. There are several little changes about the drugs administrated during CPR according to the rhythm. Given the lack of documented effect of drug therapy in improving long-term outcome from cardiac arrest, the sequence for CPR deemphasizes drug administration and reemphasizes basic life support.

The update on the new resuscitation guidelines is important to improve the quality of resuscitation and achieve better survival rates from our critical care patients.