AACN advanced critical care
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Dismal survival statistics associated with sudden cardiac arrest have led to the development of new strategies and mechanical devices aimed at improving the quality of cardiopulmonary resuscitation (CPR). The most recent American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care were published in 2005. Major changes included revisions to current practices related to airway and ventilation, circulation, and defibrillation management. ⋯ This article focuses on current strategies aimed at improving survival rates for patients with sudden cardiac arrest. New techniques and mechanical devices developed to augment cardiopulmonary resuscitation will be discussed. These strategies will most likely shape future resuscitation practices.
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The use of induced hypothermia has been considered for treatment of head injuries since the 1900s. However, it was not until 2 landmark studies were published in 2002 that induced hypothermia was considered best practice for patients after cardiac arrest. In 2005, the American Heart Association included recommendations in the postresuscitation support guidelines recommending consideration of mild hypothermia for unconscious adult patients with return of spontaneous circulation following out-of-hospital cardiac arrest due to ventricular fibrillation. This article provides an overview on the history and supportive research for inducing mild hypothermia after cardiac arrest, the pathophysiology associated with cerebral ischemia occurring with hypothermia, nursing management for this patient population, and the development of a protocol for induced hypothermia after cardiac arrest.