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Artificial ventilation in cardiopulmonary resuscitation 

Artificial ventilation in cardiopulmonary resuscitation
Chapter:
Artificial ventilation in cardiopulmonary resuscitation
Author(s):

Jasmeet Soar

and Jerry P. Nolan

DOI:
10.1093/med/9780199600830.003.0060
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date: 28 February 2020

When cardiac arrest occurs, cardiopulmonary resuscitation (CPR) should be started with chest compressions first. The use of ventilations is determined by the training of rescuers, their ability and willingness to provide rescue breaths, patient characteristics, and the underlying cause of the cardiac arrest. Trained rescuers should give two ventilations after every 30 compressions, or once the airway is secured with a tracheal tube, ventilate the patient at 10 breaths/min without any pause in chest compressions. Rescuers who are unable or unwilling to provide effective ventilation, while awaiting expert help should use compression-only CPR. Ventilations are needed for the treatment of cardiac arrest in children, when arrest is from a primary respiratory cause, or during a prolonged cardiac arrest. Choice of ventilation technique depends on rescuer skills and the airway used. Effective oxygenation and ventilation can be maintained during CPR with a tidal volume of approximately 500 mL given over an inspiratory time of 1 second. Rescuers should give supplemental oxygen in as high a concentration as possible during CPR in order to rapidly correct tissue hypoxia. Once restoration of a spontaneous circulation has been achieved the inspired oxygen should be adjusted to maintain oxygen saturation between 94 and 98%.

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