Resuscitation

Resuscitation is the process of restoring life and physiological function to a person who has suffered collapse or cardiac arrest. In clinical practice the term most commonly refers to cardiopulmonary resuscitation (CPR) and advanced cardiac life support for cardiac arrest.

CPR consists of chest compressions and rescue breaths performed to maintain circulation to the brain and vital organs until the underlying cause of arrest can be treated. High-quality chest compressions, delivered at a rate of 100 to 120 per minute and to a depth of 5 to 6 cm in adults, are the cornerstone of effective resuscitation. Early defibrillation for shockable rhythms (ventricular fibrillation and pulseless ventricular tachycardia) is the intervention most likely to restore a normal cardiac rhythm and achieve return of spontaneous circulation (ROSC).

Advanced resuscitation adds airway management (typically endotracheal intubation), intravenous or intraosseous drug administration (including adrenaline and amiodarone), and identification and treatment of reversible causes (the 4Hs and 4Ts framework). In hospital, resuscitation is performed by the cardiac arrest team; out-of-hospital resuscitation is initiated by bystanders and taken over by paramedics on arrival.

After successful resuscitation and return of spontaneous circulation, post-resuscitation care begins, guided by the post-cardiac arrest care pathway. This includes targeted temperature management, haemodynamic stabilisation, coronary angiography where indicated, and neurological prognostication. Family members are usually met by a dedicated liaison team and kept informed throughout the resuscitation process and its aftermath.