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Lazarus phenomenon is the rare spontaneous return of circulation after cardiopulmonary resuscitation attempts have stopped in someone with cardiac arrest. This phenomenon most frequently occurs within 10 minutes of cessation of resuscitation, thus passive monitoring is recommended for 10 minutes following CPR cessation. [10]
Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation, or mouth-to-mouth in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest.
The American Heart Association later adopted the concept and elaborated on it in its 1992 guidelines for cardiopulmonary resuscitation and emergency cardiac care, [12] [13] The International Liaison Committee on Resuscitation (ILCOR) echoed the concept in 1997. [1] The links of the Chain of survival are described below.
Once cardiac arrest is identified, cardiopulmonary resuscitation is commenced as per local resuscitation algorithms. With the assistance of emergency medical services and in hospital resuscitation teams, all patients with out-of hospital and in hospital arrests are assessed for their eligibility for ECPR.
Early recognition that a cardiac arrest has occurred is key to survival, for every minute a patient stays in cardiac arrest, their chances of survival drop by roughly 10%. [ 64 ] Early CPR improves the flow of blood and of oxygen to vital organs, an essential component of treating a cardiac arrest.
The 'ABC' method of remembering the correct protocol for CPR is almost as old as the procedure itself, and is an important part of the history of cardiopulmonary resuscitation. Throughout history, a variety of differing methods of resuscitation had been attempted and documented, although most yielded very poor outcomes. [42]
The endotracheal tube is a great method for patients who are comatose, have an obstructed airway, or need mechanical ventilation. The endotracheal tube also allows suctioning of the lower respiratory tract. Drugs that can be inserted through the endotracheal tube during cardiac arrest are discouraged.
Bag valve mask. Part 1 is the flexible mask to seal over the patients face, part 2 has a filter and valve to prevent backflow into the bag (prevents patient deprivation and bag contamination) and part 3 is the soft bag element which is squeezed to expel air to the patient