Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T17:45:43.111Z Has data issue: false hasContentIssue false
  • English
  • Français

Recommendations for Cardiopulmonary Cerebral Resuscitation

Published online by Cambridge University Press:  17 February 2017

R. von Janik
R. von Janik
Affiliation:
Department of Anesthesia, Universitatskliniken, Mainz, West Germany
Get access Rights & Permissions [Opens in a new window]

Extract

Irreversible brain damage may occur when cessation of circulation (cardiac arrest) lasts longer than a few minutes. Resuscitative measures, however, can be initiated anywhere without use of equipment, by trained individuals, ranging from the lay public to the physician specialist. The history of modern cardiopulmonary resuscitation (CPR) includes the following steps during the past 30 years:

1. Proof that ventilation with the operator's exhaled air is physiologically sound and superior to manual chestpressure arm-lift maneuvers (Elam, Safar, Gordon).

2. Re-discovery and development of external cardiac compression (Kouwenhoven).

3. Demonstration of the need to combine positive pressure ventilation with external cardiac compression (Safar).

4. Intrathoracic and external electric defibrillation of the heart (Prevost, Zoll, Beck).

For didactic purposes, Safar has divided cardiopulmonary - cerebral resuscitation (CPCR) into three phases and nine steps, using the letters of the alphabet from A to I.

Basic Life Support is for emergency tissue oxygenation and consists of: A) airway control; B) breathing support, artificial ventilation of the lungs; and C) circulation support, recognition of pulselessness and establishment of an artificial circulation by cardiac compressions.

Advanced Life Support addresses restarting spontaneous circulation and stabilizing the cardiopulmonary system. Phase II consists of steps: D) drugs and fluids by intravenous infusion; E) electrocardiography; and F) fibrillation treatment by electric countershock.

Prolonged Life Support represents brainoriented intensive care for multiple organ failure in the post-resuscitative period. Phase III should be continued until the patient regains consciousness, brain death has been certified, or his underlying disease makes further resuscitation efforts useless.

Type
Section Three—Definitive Medical Care
Information
Prehospital and Disaster Medicine , Volume 1 , Issue 2 , Summer 1985 , pp. 149 - 151
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Ahnfeld, FW. Sekunden entscheiden - Lebensrettende Sofortmassnahmen Heidelberger Taschenbücher, Bd32. New York: Springer-Verlag, 1967.Google Scholar
2 Ahnefeld, FW, Dolp, R. Erstvertsorgung Verletzter am Unfallort. Dtsch med Wschr 1974; 99:1026.CrossRefGoogle Scholar
3American Heart Association. Standards for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC). JAMA 1974; Suppl 227. 1985 in press.Google Scholar
4 Benson, DW, Jude, JR, Kouwenhoven, WB. External cardiac massage. Anest Analg 1963; 42:75.Google Scholar
5 Brooks, DK. Resuscitation. London: Arnold, 1967.Google Scholar
6 Crehan, JP, Nicholson, MJ. A cardiac monitor-pacemaker, its role in clinical anesthesia. JAMA 1963; 185:604.Google Scholar
7 Frey, R, Safar, P. Die äussere Herzwiederbelebung. Dtsch Med Wschr 1962; 87:857.Google Scholar
8 Frey, R, Kolb, E, Henneberg, U. Gefahren der äusseren Hertzwiederbelebung. Dtsch Med Wschr 1964; 89:630.Google Scholar
9 Frey, R, Ahnefeld, FW. Schockbe kämpfung und Wiederbelebung von Atmung und Kreislauf. Wehrtechn Hefte 1964; H.12,471.Google Scholar
10 Frey, R, Nolte, H. Beatmung am Unfallort dtsch Arzt und Laien Therapiewoche 1965; 15:481.Google Scholar
11 Frey, R, Benzer, H, Hogen, W, et al. Lehrbuch der Anaesthesiologie, Reanimation und Intensiv therapie. New York: Springer-Verlag, 1977, pp.569–588.Google Scholar
12 Gordon, AS. Standards for cardiopulmonary resuscitation and emergency cardiac care. American Heart Association 1973:1–53.Google Scholar
13 Horatz, K. Komplikationen bei der Wiederbelebung. In, Anesthesiologie und Wiederbelebung Bd 15. New York: Springer-Verlag, 1966.Google Scholar
14 Lawin, P. Praxis der Intensivbehandlung. Stuttgart: Georg Thieme Verlag, 1971:S582.Google Scholar
15 Lee, JA, Atkinson, RS. A synopsis of anesthesia. 7th ed. Bristol UK: John Wright, 1973.Google Scholar
16 Nolte, H, Frey, R. Welche einfachen Beatmungsmethoden sind bei der Reanimation am Unfallort empfehlenswert. Münch med Wschr 1965; 107:1664.Google Scholar
17 Rosen, MR, Hoffman, BF. Mechanisms of action of antiarrhythmic drugs. Circulat Res 1973; 32:1.Google Scholar
18 Safar, P, Brown, TC, Holtey, WC, et al. Ventilation and circulation with closedchest massage in man. JAMA 1961; 176:574.Google Scholar
19 Safar, P. Cardiopulmonary Cerebral Resuscitation: A Manual for Physicians and Paramedical Instructors (World Federations of Societies of Anaesthesiologists). Philadelphia: W.B. Saunders, 1981.Google Scholar
20 Safar, P, Elam, JO, et al. Resuscitative principles for sudden cardiopulmonary collapse. Dis Chest 1963; 43:34.Google Scholar
21 Safar, P, Brose, RA. Ambulance design and equipment for resuscitation. Arch Surg 1965; 90:343.Google Scholar
22 Snow, JC. Manual of Anesthesia. Boston: Little, Brown & Co., 1977.Google Scholar
23 Tammisto, T, Takki, S. Competence of medical students in cardiopulmonary resuscitation. Acta Anesth Scand 1972; 16:246.Google Scholar