The Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency
Cardiovascular Care (ECC)1 are probably the
most widely implemented and best-known guidelines in medicine. In the setting
of cardiac arrest, health care professionals want and need simple, practical,
and effective guidelines. As the American Heart Association (AHA) and International
Liaison Committee on Resuscitation (ILCOR) revise their Consensus on Science
and Treatment Guidelines in 2005, it is imperative to assess how these guidelines
are developed. Despite the major reassessment and publication of new CPR and
ECC guidelines every 5 to 8 years for the past 3 decades, survival from cardiac
arrest remains dismal.2 Have the guidelines
and guideline development process improved or compromised the treatment of
patients in cardiac arrest? Do they reflect the reality of cardiac arrest
treatment? Are they responsive, or impenetrable, to new ideas and concepts
in ECC? Are there ways to improve the guidelines process and, therefore, the
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The Rational Clinical Examination
With the development of closed-chest cardiac massage in 1960 and the creation of intensive care...
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