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British Medical Bulletin Advance Access originally published online on January 28, 2009
British Medical Bulletin 2009 89(1):79-91; doi:10.1093/bmb/ldp002
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Advanced life support update

Natalie Husselbee{dagger}, Robin P. Davies{dagger} and Gavin D. Perkins{dagger},{ddagger},*

{dagger} Heart of England NHS Trust, Birmingham, West Midlands B9 5SS, UK
{ddagger} Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK

* Correspondence to: Dr G. D. Perkins, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK E-mail: g.d.perkins{at}warwick.ac.uk

Introduction: Cardiac arrest is a common emergency in acute hospitals. The Resuscitation Council (UK) Advanced Life Support Guidelines provide a systematic approach to cardiac arrest recognition, treatment and aftercare. This review provides an update on the current treatment guidelines and identifies areas where these may be strengthened.

Methods: The evidence informing the 2005 Resuscitation Guidelines is reviewed. New evidence since the publication of the guidelines was identified by searching Medline (December 2005–December 2008) with the term heart arrest or advanced life support.

Results: Opportunities for strengthening the chain of survival exist for each link. These include better recognition of critically ill patients at risk of cardiac arrest, improved quality of cardiopulmonary resuscitation, defibrillation strategies, which minimize pre- and post-shock pauses and development of post-resuscitation care bundles.

Conclusion: Emerging evidence suggests opportunities where Resuscitation Guidelines could be strengthened by focusing on specific aspects of the chain of survival.

Keywords: advanced life support • defibrillation • resuscitation

Accepted for publication January 6, 2009.


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