• Natalie Husselbee, Robin P Davies, and Gavin D Perkins.
• Warwick Medical School, University of Warwick, Coventry, UK.
• Br. Med. Bull. 2009 Jan 1;89:79-91.

IntroductionCardiac arrest is a common emergency in acute hospitals. The Resuscitation Council (UK) Advanced Life Support Guidelines provide a systematic approach to cardiac arrest recognition, treatment and aftercare. This review provides an update on the current treatment guidelines and identifies areas where these may be strengthened.MethodsThe evidence informing the 2005 Resuscitation Guidelines is reviewed. New evidence since the publication of the guidelines was identified by searching Medline (December 2005-December 2008) with the term heart arrest or advanced life support.ResultsOpportunities for strengthening the chain of survival exist for each link. These include better recognition of critically ill patients at risk of cardiac arrest, improved quality of cardiopulmonary resuscitation, defibrillation strategies, which minimize pre- and post-shock pauses and development of post-resuscitation care bundles.ConclusionEmerging evidence suggests opportunities where Resuscitation Guidelines could be strengthened by focusing on specific aspects of the chain of survival.

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