WHATS NEW ON CARDIOPULMONARY-RESUSCITATIO N

A strong consensus was reached for several changes in the guidelines f or cardiopulmonary resuscitation (CPR) and emergeny cardiac care (ECC) in the 1992 conference on CPR and ECC held by the Emergency Cardiac C are Committee of the American Heart Association. These new recommendat ions, together with differing recommendations of the European Resuscit ation Council, are described. An unresponsive person with spontaneous respirations should be placed in the recovery position if no cervical trauma is suspected. Compared with endotracheal intubation, other airw ay-protecting devices such as combination esophageal-tracheal tubes ar e of minor acceptance. During ventilation, the time for filling the lu ngs is increased to 1.5-2 s to decrease the likelihood of gastric insu fflation. Delivery of IV drugs can be enhanced by an IV flush of sodiu m chloride. In endotracheal drug administration, higher doses and drug dilution are recommended. In infants and children up to 6 years of ag e, the value of intraosseous drug administration is emphasized. For pu lseless adult victims, the initial dosage of epinephrine of 1 mg I.V r emains unchanged. For repeat doses, high-dose epinephrine up to 0.1 mg /kg is classified as of uncertain but possible efficacy. For lidocaine , the recommended I.V. dosage is 1.5 mg/kg. Sodium bicarbonate and cal cium are not routinely recommended for resuscitation. For atropine, th e maximum dose is 0.04 mg/kg. If hypomagnesaemia is present in recurre nt and refractory ventricular fibrillation, it should be corrected by administration of 1 to 2 g magnesium sulfate I.V. Thrombolytic agents are classified as useful and effective in acute myocardial infarction and should be administered as early as possible. Glucose-containing fl uids are discouraged for resuscitative efforts.