The duration of cardiac arrest is the most important prognostic factor [29]. In general, chest compressions should be continued at least as long as VF persists. Prolonged chest compressions are less likely to succeed if there is no ROSC within half an hour. However, case reports with exceptional ROSC are well documented and each decision to terminate efforts should be made individually. Any family members and patients’ loved ones who witness chest compressions should be treated with consideration and sensitivity. Complications Life-threatening complications of chest compressions LY2157299 are extremely rare [24]. Such complications occur less frequently than 1% [30–35]. If hypotension is noted following

ROSC then cardiogenic shock and abdominal injury are the most important complications of chest compressions that should be considered [31]. Rib fractures are the most frequent complication, LY2606368 supplier with an incidence of 1/3 at autopsy [30]. However, rib fractures were noted in only 2% of non-arrest patients who received chest compressions from a bystander [5]. Following successful ROSC all patients should be re-evaluated for resuscitation-related injuries [28]. Summary

High quality chest compressions are proven to save lives. If an unresponsive patient has no definite pulse or is not breathing normally then the responder should assume that this patient is in cardiac arrest, activate the emergency response system and immediately start chest compressions. Push hard and fast over the center of the chest. Minimize interruptions of chest compressions and aggressively rotate compressors. Following successful ROSC place the patient in the recovery position and re-evaluate for resuscitation-related injuries. If there is no reasonable chance for ROSC then the decision to terminate efforts should be made by the leader of the emergency response team. Any family members Chlormezanone witnessing chest compressions should be treated with sensitivity and respect. References 1. Kouwenhoven W, Jude J, Knickerbocker G: Closed-chest cardiac massage. JAMA 1960, 173:1064–7.PubMedCrossRef

2. Abella BS, et al.: Chest compression rates during cardiopulmonary resuscitation are suboptimal: a prospective study during in-hospital cardiac arrest. Circulation 2005,111(4):428–34.PubMedCrossRef 3. Morrison LJ, et al.: Part 3: ethics: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010,122(18 Suppl 3):S665–75.PubMedCrossRef 4. Berg RA, et al.: Part 5: adult basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010,122(18 Suppl 3):S685–705.PubMedCrossRef 5. White L, et al.: Dispatcher-assisted cardiopulmonary resuscitation: risks for patients not in cardiac arrest.