Cardiopulmonary resuscitation developed over the past one half century largely from empiric science and consensus opinions and recommendations. Treatment algorithms and protocols were originally developed to summarize existing recommendations for systematic and regimented use by a heterogenous group of health care providers. Now, resuscitation science and health care teams are focusing on major issues and continuing questions as sudden death rates remain undaunted and the population at risk is rapidly increasing.
For the first time, the international resuscitation community has developed an international consensus on Guidelines for Resuscitation and Emergency Cardiac Care. More than 400 basic scientists, clinical trial investigators, and educators defined common priority and scientific areas during the Evidence Evaluation International Meeting in 1999. The science of resuscitation and emergency cardiac care was reviewed for evidence-based support in randomized clinical trials. In 2000, this review was used as a foundation to structure international guidelines. The participants from seven resuscitation councils and foundations realized that regional differences in systems may exist, but the underlying science should be the same. Presented in this article are some of the major issues and controversies discussed in adult advanced cardiac life support, primarily focusing on the major problem of prehospital adult cardiac arrest.
Professor of Medicine and Surgery, Penn State University College of Medicine, and Science Editor, American Heart Association International Guidelines 2000 on Resuscitation and Emergency Cardiovascular Care
Correspondence to John M. Field, MD, Division of Cardiology, Penn State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA; e-mail: email@example.com