Cardiopulmonary resuscitation

Abstract

Performing cardiopulmonary resuscitation is a key competency for healthcare professionals. Training in immediate and advanced life support is a requirement for UK doctors; this is depicted in the Foundation training programme competencies and in the Internal Medicine Training curriculum. It requires being able to identify unwell patients, perform a structured assessment and treatment approach, master relevant procedural aspects and demonstrate non-technical skills including leading the resuscitation team. The Resuscitation Council UK has recently provided updated guidance on basic and advanced life support. These guidelines align with similar international guidelines, taking into account evidence from clinical trials of cardiac arrest management and national data on cardiac arrest outcomes in the community and in the hospital. The guidance includes considerations regarding individuals with suspected or confirmed coronavirus disease (COVID-19). The complex ethical aspects around escalation of care, advance care planning, 'Do Not Attempt Cardiopulmonary Resuscitation' decisions and communication with patients and their loved ones are also discussed. This chapter summarizes the current guidance on cardiopulmonary resuscitation.

Keywords: Advanced life support; basic life support; cardiac arrest; cardiopulmonary resuscitation; defibrillation; ‘Do Not Attempt CPR’.

Figure 1

Adult basic life support algorithm 2021. Reproduced with the kind permission of the Resuscitation Council UK.

Figure 2

Advanced life support algorithm 2021. Reproduced with the kind permission of the Resuscitation Council UK. PaCO₂, partial pressure of carbon dioxide in arterial blood; SpO₂, blood oxygen saturation.

Figure 3

Reproduced with the kind permission of the Resuscitation Council UK. ET, endotracheal; HCW, healthcare worker.