Chapter 13
Cardiac arrest: clinical management
Jon C. Rittenberger,
Vincent N. Mosesso Jr.,
Jon C. Rittenberger
Search for more papers by this authorVincent N. Mosesso Jr.
Search for more papers by this authorJon C. Rittenberger,
Vincent N. Mosesso Jr.,
Jon C. Rittenberger
Search for more papers by this authorVincent N. Mosesso Jr.
Search for more papers by this authorBook Editor(s):David C. Cone MD,
Jane H. Brice MD, MPH,
Theodore R. Delbridge MD, MPH,
J. Brent Myers MD, MPH,
David C. Cone MD
Professor of Emergency Medicine
Yale University School of Medicine, New Haven, Connecticut
Search for more papers by this authorJane H. Brice MD, MPH
Professor of Emergency Medicine
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Search for more papers by this authorTheodore R. Delbridge MD, MPH
Executive Director
Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland
Search for more papers by this authorJ. Brent Myers MD, MPH
Chief Medical Officer ESO Associate Medical Director
Wake County EMS, Raleigh, North Carolina
Search for more papers by this authorFirst published: 18 August 2021
Summary
Cardiac arrest requires immediate, high-quality interventions for successful resuscitation. Rapid recognition, immediate initiation of chest compressions, and prompt defibrillation for shockable rhythms are the foundations of management. The quality of compressions is related to the likelihood of survival. Compressions must be of adequate depth, with full recoil, at a rate of 100-120/minute, and performed without interruption. Ventilation efforts should not negatively affect or delay the delivery of chest compressions and defibrillation, especially during the initial resuscitation of patients with primary cardiac arrest. Intensive post cardiac arrest care improves the likelihood of discharge to home in good neurological condition. It should include maintenance of adequate perfusion, normoxia and normocarbia, therapeutic hypothermia, early cardiac catheterization, and comprehensive critical care.
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