Johns Hopkins Bayview Medical Center, USA
Title: 2014 update on cardio pulmonary resuscitation
Amballur D John is currently an Assistant Professor of Anesthesiology and Critical Care Medicine, Director of Student Education, Department of Anesthesia at Johns Hopkins Bayview Medical Center, Baltimore, USA. He did his B.A. from Harvard University and his M.D. from New York Medical College, USA. He has trained in Internal Medicine Residency at Metro West Medical Center, Anesthesiology and Critical Care Medicine Residency at Johns Hopkins Hospital and his Fellowship in Cardiac Anesthesiology from Johns Hopkins Hospital, Cardiac Anesthesiology from Massachusetts General Hospital.
It is well over 50 years since the modern era of Cardio-Pulmonary Resuscitation began with Dr. Peter Safar's successful resuscitations of people who had suffered cardiac arrest. These successful resuscitations by Dr. Safar were performed at the former Baltimore City Hospital (now known as the Johns Hopkins Bayview Medical Center). Laboratory work on cardio- pulmonary resuscitation began in earnest in the late 1950's and early 1960's. By the late 1960's the first set of national guidelines were promulgated. Leadership in the field of cardio pulmonary resuscitation has changed from Anesthesiologists and Critical Care Physicians to cardiologists and the American Heart Association.
Despite many advances in the field of medicine and our increased knowledge and understanding of resuscitation, success rates as defined by intact neurological outcome in those surviving to hospital discharge will remain low 15%-20%. Is there a difference between in hospital and out of hospital arrests? Does the patient's underlying medical condition matter? Have newer in-hospital Rapid Response Teams and Code Teams helped? Is it possible to quantify factors that lead to worse outcomes or improved outcomes? What are the novel therapies and when is it appropriate to use such treatments? These questions remain to be answered.