Cardiac Arrest - Management

Management

Sudden cardiac arrest may be treated via attempts at resuscitation. This is usually carried out based upon basic life support (BLS) / advanced cardiac life support (ACLS), pediatric advanced life support (PALS) or neonatal resuscitation program (NRP) guidelines. Several organisations promote the idea of a "chain of survival". The chain consists of the following "links":

• Early recognition - If possible, recognition of illness before the patient develops a cardiac arrest will allow the rescuer to prevent its occurrence. Early recognition that a cardiac arrest has occurred is key to survival - for every minute a patient stays in cardiac arrest, their chances of survival drop by roughly 10%.
• Early CPR - improves the flow of blood and of oxygen to vital organs - an essential component of treating a cardiac arrest. In particular, by keeping the brain supplied with oxygenated blood, chances of neurological damage are decreased.
• Early defibrillation - is effective for the management of ventricular fibrillation and pulseless ventricular tachycardia If defibrillation is delayed the rhythm is likely to degenerate into asystole for which outcomes are worse.
• Early advanced care - Early Advanced Cardiac Life Support is the final link in the chain of survival.

If one or more links in the chain are missing or delayed, then the chances of survival drop significantly.

These protocols are often initiated by a Code Blue, which usually denotes impending or acute onset of cardiac arrest or respiratory failure, although in practice, Code Blue is often called in less life-threatening situations that require immediate attention from a physician.