Elsevier

Resuscitation

Volume 67, Supplement 1, December 2005, Pages S39-S86
Resuscitation

European Resuscitation Council Guidelines for Resuscitation 2005: Section 4. Adult advanced life support

https://doi.org/10.1016/j.resuscitation.2005.10.009Get rights and content

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The problem

This new section of the guidelines stresses the importance of preventing in-hospital cardiac arrest. Fewer than 20% of patients suffering an in-hospital cardiac arrest will survive to go home.1, 2 Most survivors have a witnessed and monitored VF arrest, primary myocardial ischaemia as the cause, and receive immediate defibrillation.

Cardiac arrest in patients in unmonitored ward areas is not usually a sudden unpredictable event, nor is it usually caused by primary cardiac disease. These patients

4b. In-hospital resuscitation

After in-hospital cardiac arrest, the division between basic life support and advanced life support is arbitrary; in practice, the resuscitation process is a continuum and is based on common sense. The public expect that clinical staff can undertake cardiopulmonary resuscitation (CPR). For all in-hospital cardiac arrests, ensure that:

  • cardiorespiratory arrest is recognised immediately

  • help is summoned using a standard telephone number

  • CPR is started immediately using airway adjuncts, e.g. a pocket

Drugs and fluids for cardiac arrest

This topic is divided into: drugs used during the management of a cardiac arrest; anti-arrhythmic drugs used in the peri-arrest period; other drugs used in the peri-arrest period; fluids; and routes for drug delivery. Every effort has been made to provide accurate information on the drugs in these guidelines, but literature from the relevant pharmaceutical companies will provide the most up-to-date data.

Drugs used during the treatment of cardiac arrest

Only a few drugs are indicated during the immediate management of a cardiac arrest, and

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