Indications
- Cardiac Arrest (see Cardiac Arrest)
Technique
XXX
- xxx
Minimally Interrupted Cardiac Resuscitation (MICR) (Cardiocerebral Resuscitation)
- History: protocol was developed at the University of Arizona Sarver Heart Center and was first instituted in Tucson, Arizona, in late 2003
- Rationale: protocol focuses on maximizing myocardial and cerebral perfusion via various features
- Minimization of Interruption of Chest Compressions
- Provision of Immediate Preshock Chest Compressions for Prolonged Ventricular Fibrillation (VF)
- Delay/Elimination in Endotracheal Intubation
- Minimization of Positive Pressure Ventilation
- Decrease in the Time Interval to Intravenous Epinephrine Administration
- Clinical Efficacy
- Study of Minimally Interrupted Cardiac Resuscitation (MICR) by Emergency Services Personnel in Out-of-Hospital Cardiac Arrest (JAMA, 2008) [MEDLINE]: MICR improved survival to hospital discharge
Family Presence During Cardiopulmonary Resuscitation
- French Study of Allowing Families to Witness Resuscitation (2013) [MEDLINE]: n = 570; relatives were allowed the option to witness CPR
- Post-traumatic stress disorder (PTSD) was lower in the group who witnessed CPR (odds ratio: 1.7)
- Symptoms of anxiety/depression were lower in the group who witnessed CPR
- Witnessing CPR had no adverse effects on patient survival, health care team mental stress, or medicolegal proceedings
- Cautions of study: study included a designated support assistant who carefully explained the CPR efforts to the family member
Physiology
- Increased Dead Space Ventilation with Acute Hypoventilation/Ventilatory Failure (see Acute Hypoventilation, [[Acute Hypoventilation]])
- xxxx
- xxxx
- xxxx
Adverse Effects of Cardiopulmonary Resuscitation
Cardiovascular Adverse Effects
- xxx
Pulmonary Adverse Effects
- Pneumothorax (see Pneumothorax, [[Pneumothorax]])
Rheumatologic/Orthopedic Adverse Effects
- Rib Fracture
Other Adverse Effects
- xx
References
- Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest. JAMA. 2008 Mar 12;299(10):1158-65. doi: 10.1001/jama.299.10.1158 [MEDLINE]
- Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest. JAMA. 2010 Oct 6;304(13):1447-54. doi: 10.1001/jama.2010.1392 [MEDLINE]
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Active chest compression-decompression for cardiopulmonary resuscitation. Cochrane Database Syst Rev 2013 Sep 20;9:CD002751 [MEDLINE]
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Family presence during cardiopulmonary resuscitation. N Engl J Med 2013;368(11):1008-1018 [MEDLINE]
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Weighing the benefits and burdens of witnessed resuscitation. N Engl J Med 2013;368(11):1058-1059 [MEDLINE]
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Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitations in out-of-hospital cardiac arrest. The LINC randomized trial. JAMA. 2014 Jan 1;311(1):53-61. doi: 10.1001/jama.2013.282538 [MEDLINE]