KEY POINTS

1. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care represents the first internationally developed and accepted resuscitation recommendations related to basic and advanced life support interventions.

---

2948

2. One- and two-person CPR for adult victims of cardiac arrest should be performed at a rate of 100 compressions per minute with two rescue breaths interposed after 15 chest compressions. Although interposed abdominal compression, active compression-decompression, and pneumatic vest CPR confer some improvement in circulation and ventilation parameters, hospital discharge rates are unchanged when compared with standard CPR.
3. Defibrillation, not antiarrhythmic therapy, is the only established and universally accepted treatment of ventricular fibrillation.
4. Current guidelines recommend community-based defibrillation for victims of cardiac arrest within 5 minutes and for medical facility-based defibrillation within 3 ± 1 minute of collapse. Distribution of automated external defibrillators in strategic locations in the community and medical facilities should accommodate these recommendations.
5. Nonescalating biphasic, truncated, impedance-compensated defibrillation waveforms represent current technology incorporated in both automated and manual cardiac defibrillators; they allow defibrillation efficacy equivalent to that of monophasic defibrillators, yet size, weight, and maintenance are significantly reduced.
6. Defibrillation energies in children are not conclusively established, but initial energies of 2 J/kg followed by 4 J/kg (if indicated) appear to be effective.
7. Amiodarone and vasopressin are pharmacologic agents that demonstrate some benefit in improving defibrillation success after ventricular fibrillation.
8. In tachyarrhythmias, a 12-lead ECG diagnosis of the etiology of the underlying rhythm is recommended. For patients unstable because of tachyarrhythmias, immediate cardioversion is indicated. For hemodynamically stable patients, institution of medical therapy should be based on 12-lead ECG findings and the presence or absence of left ventricular failure. The intent of these most recent guidelines is to limit the administration of antiarrhythmic medications for the purpose of reducing the proarrhythmic effects of these agents.
9. Maintaining current certification in basic and advanced life support is mandatory for proficient and effective intervention in victims of cardiac arrest.