After opening the airway (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal. Using the heel of one or both hands, press straight down on (compress) the chest about 2 inches (approximately 5 centimeters) but not greater than 2.4 inches (approximately 6 centimeters). The 2010 AHA guidelines strongly advised induced hypothermia (32-34C) for patients with out-of-hospital VF/pVT cardiac arrest and post-ROSC coma (the absence of purposeful movements) and encouraged consideration of induced hypothermia for most other comatose patients after cardiac arrest. Other recommendations include confirming endotracheal tube placement using an exhaled carbon dioxide detector; using less than 100 percent oxygen and adequate thermal support to resuscitate preterm infants; and using therapeutic hypothermia for infants born at 36 weeks' gestation or later with moderate to severe hypoxic-ischemic encephalopathy. 2013 May 8. According to the recommendations, suctioning is only necessary if the airway appears obstructed by fluid. [QxMD MEDLINE Link]. If the bradycardia evolves into pulseless arrest, proceed to the pulseless arrest algorithm. How do the prognoses for standard cardiopulmonary resuscitation (CPR) and compression-only CPR (COCPR) compare? [8] However, other studies have shown opposite results, and it is currently accepted that COCPR is superior to standard CPR in out-of-hospital cardiac arrest. [49, 48, 54] In addition, the AHA guidelines recommend considering kidney or liver donation in patients who do not have ROSC after resuscitation efforts and would otherwise have termination of efforts. With the other hand, gently lift the chin forward to open the airway. Be careful not to provide too many breaths or to breathe with too much force. What is the efficacy of mechanical cardiopulmonary resuscitation (CPR) devices? [21, 22], It has also been demonstrated that out-of hospital cardiac arrests occurring in public areas are more likely to be associated with initial ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) and have better survival rates than arrests occurring at home. [46] : The 2020 update added a 'Recovery' link to the chain of survival for both in-hospital cardiac arrests (IHCAs) and out-of-hospital cardiac arrests (OHCAs). Akahane M, Ogawa T, Koike S, et al. Emerg Med J. Excitement and apprehension accompany this life saving effort. Unlike BLS, PALS typically involves a coordinated team of trained responders who are able to initiate several processes simultaneously. If two or more people are available to help, one person calls 911 and then gets an AED, while the other person performs CPR (30 compressions:2 breaths). Once the heart rate increases to more than 60 bpm, chest compressions are stopped. J Forensic Sci. [13, 14, 15, 16, 17] A study by Akahane et al suggested that survival rates may be higher in men but that neurologic outcomes may be better in women of younger age, though the reasons for such sex differences are unclear.
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