Resuscitation

The continuum of critical illness for an individual can span the period before and beyond hospital admission. Resuscitation is often required outside the critical care environment, and the ‘cardiac arrest’ team has evolved to use a more proactive, early intervention approach, utilising a range of rapid response systems and instruments to detect deterioration in patients’ clinical status (see Chapter 3). It is well recognised that improved outcomes from cardiac arrest are dependent on early recognition and initiation of the ‘chain of survival’.1 This chapter introduces the resuscitation systems and processes in both the pre-hospital and the in-hospital settings. The chain of survival provides a framework for the management of the person experiencing cardiac arrest and resuscitation in specific circumstances. The chapter expands on the final link in the chain, advanced life support, to outline advanced airway management, rhythm recognition, administration of medications and post-resuscitation care. Resuscitation involves many moral and ethical issues, such as family presence during resuscitation, deciding when to cease or initiate resuscitation and near-death experiences (see Chapter 5).