Chapter 78
- Cardiopulmonary Resuscitation: Basic and Advanced Life Support
- Brian P. McGlinch
- Roger D. White
Although the history of resuscitation can be traced to at least
biblical times,[1]
contemporary approaches to cardiopulmonary
resuscitation (CPR) date back to 1966, when a National Academy of Sciences National
Research Council conference generated consensus standards for the performance of
CPR.[2]
Since that time, successive conferences
have reviewed the practice of CPR in light of available experimental and clinical
data and have prepared revisions of previous standards.[3]
[4]
[5]
[6]
[7]
[8]
The most
recent recommendations, Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care,[8]
are the first internationally
recognized resuscitation guidelines developed by experts from the American Heart
Association (AHA) and the European Resuscitation Council; as such, these guidelines
represent a variety of countries, cultures, and medical specialties. Each intervention
included in the new guidelines has undergone comprehensive evidence-based evaluation
of the scientific information available supporting its use in emergency cardiovascular
care and resuscitation. Both basic life support (BLS) and advanced cardiac life
support (ACLS) are established on credible foundations and have enjoyed widespread
acceptance in the emergency cardiovascular care community. Indicative of this acceptance
is the widespread popularity of the AHA BLS and ACLS training programs and related
training materials. The intent of this chapter is to review the premise, rationale,
and techniques for the performance of both BLS and ACLS in light of current understanding
and as published in AHA textbooks on BLS[9]
and
ACLS.[8]
It is not the intent of this chapter to
restate the performance of all BLS CPR procedures, which can be reviewed in the guidelines
and also in the AHA BLS text.[9]
Rather, both BLS
and ACLS are reviewed within the context of their application by anesthesiologists
in operating rooms, intensive care units (ICUs), and other patient care environments.
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