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Contemporary Reviews in Critical Care Medicine |

Improving CPR performance

Boulos S. Nassar, MD MPH; Richard Kerber, MD
Author and Funding Information

The authors have no conflicts to disclose with regards to the content of this manuscript. No funding was received for this study

adivision of Pulmonary, Critical Care and Occupational Medicine

bdivision of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA

Corresponding author: Boulos S. Nassar, MD MPH, Division of Pulmonary Diseases, Critical Care, and Occupational Medicine Department of Internal Medicine: C 326-GH University of Iowa Hospitals and Clinics 200 Hawkins Drive Iowa City, IA 52241.


Copyright 2017, . All Rights Reserved.


Chest. 2017. doi:10.1016/j.chest.2017.04.178
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Abstract

Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Key steps health care systems can take to enhance the quality of CPR and, potentially, to improve outcomes, include optimizing chest compressions; avoiding hyperventilation; encouraging intraosseus access, and monitoring capnography. Feedback devices provide instantaneous guidance to the rescuer, improve rescuer technique and could impact patient outcomes. New technologies promise to improve the resuscitation process: mechanical devices standardize chest compressions; capnography guides resuscitation efforts and signals the return of spontaneous circulation (ROSC); intraosseous devices minimize interruptions to gain vascular access. This review aims at identifying a discreet group of interventions that healthcare systems can employ to raise their standard of cardiac resuscitation.


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