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Adult Basic and Advanced Life Support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
AHA・2025・31 ページ · 弁膜症・大動脈・末梢・肺循環 · 集中治療・救急・蘇生
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Circulation1 TOP 10 TAKE-HOME MESSAGES FOR ADULT BASIC LIFE SUPPORT MANAGEMENT1 1 In adult cardiac arrest, resuscitation should gener-1 5 When ventilating adult patients in cardiac arrest, it1 10 During adult cardiac arrest, it is reasonable for res-2 PREAMBLE2 INTRODUCTION2 Scope of the Guidelines4 Organization of the Writing Group4 Class of Recommendation and Level of Evidence5 Guideline Structure6 Document Review and Approval7 REFERENCES7 Updated AHA Algorithms for Adult Basic Life Support and FBAO8 SEQUENCE OF RESUSCITATION8 Recognition of Cardiac Arrest8 1 C-LD8 Synopsis8 Recommendation-Specific Supportive Text8 1 Assessment of patient unresponsiveness and8 REFERENCES8 1 Breckwoldt J, Schloesser S, Arntz HR. Perceptions of collapse and8 INITIATION OF RESUSCITATION9 Initiation of Resuscitation: Lay Rescuer (Untrained or Trained)9 1 B-NR9 1 C-LD9 Recommendation-Specific Supportive Text9 1 Immediate initiation of chest compressions is one9 Initiation of Resuscitation: Health Care Professional10 1 C-LD10 Recommendation-Specific Supportive Text10 1 The circulation, airway, and breathing approach for10 2 Numerous studies have shown improved outcomes10 REFERENCES10 11 Williamson F, Heng PJ, Okubo M, Mejias AM, Chang WT, Douma M, Carlson11 OPENING THE AIRWAY11 Opening the Airway in Adults in Cardiac Arrest11 1 C-EO11 Recommendation-Specific Supportive Text12 1 The head tilt–chin lift is an effective technique to12 3 Oropharyngeal and nasopharyngeal airway adjuncts12 4 There is no evidence that cricoid pressure facili-12 Opening the Airway After Head and Neck Trauma12 1 C-EO12 Recommendation-Specific Supportive Text12 2 Maintaining a patent airway and providing ade-12 REFERENCES12 METRICS FOR HIGH-QUALITY CPR13 Positioning and Location for CPR13 1 B-NR13 1 C-LD13 1 C-EO13 Recommendation-Specific Supportive Text13 1 Rescuer position in relationship to the patient can13 3 The ability to safely provide high-quality CPR should14 5 Dominant hand placement on the sternum may14 6 While it is preferred to perform chest compressions14 Chest Compression Fraction and Pauses15 1 C-LD15 Recommendation-Specific Supportive Text16 1 An increase in the overall hands-on time (CCF)16 2 Pulse checks and rhythm checks are common rea-16 3 Immediate resumption of chest compressions after16 4 Chest compression depth begins to decrease after16 90 to 120 seconds of CPR, although compression16 6 Minimizing interruptions in CPR and maintaining16 a CCF of at least 60% has been associated with16 Chest Compression Depth and Rate in Adult Cardiac Arrest16 1 B-NR16 Recommendation-Specific Supportive Text17 2 A 2024 ILCOR scoping review60 addressing17 3 A 2020 ILCOR scoping review identified 11 obser-17 5 The 2020 Guidelines recommended a 50% duty17 REFERENCES17 1 Foo NP, Chang JH, Lin HJ, Guo HR. Rescuer fatigue and cardiopulmonary17 18 Kusunoki S, Tanigawa K, Kondo T, Kawamoto M, Yuge O. Safety of the inter-18 VENTILATION AND COMPRESSION-TO- VENTILATION RATIO19 Fundamentals of Ventilation During Adult Cardiac Arrest19 Recommendation-Specific Supportive Text19 1 Both mouth-to-mouth breaths and bag-mask ven-19 2 Ventilation during chest compressions presents a20 3 Bag-mask ventilation is a challenging skill that20 Ventilation During Adult Cardiac Arrest: Special Circumstances20 Recommendation-Specific Supportive Text20 1 Mouth-to-nose ventilation may be necessary if20 2 Effective ventilation of an adult patient with a tra-20 Ventilation of Adults With Spontaneous Circulation (Respiratory Arrest)21 1 C-LD21 Recommendation-Specific Supportive Text21 1 A study of 14 patients who underwent general21 2 A randomized trial in critically ill apneic adult21 REFERENCES21 COMPRESSION-TO-VENTILATION RATIO IN ADULT CARDIAC ARREST22 Synopsis22 Recommendation-Specific Supportive Text22 1 and 2. The majority of studies report no difference in22 REFERENCES22 1 Bielski K, Smereka J, Chmielewski J, Pruc M, Chirico F, Gasecka A, Litvinova22 DEFIBRILLATION DURING ADULT CARDIAC ARREST23 Pads for Defibrillation in Adult Cardiac Arrest23 Synopsis23 Recommendation-Specific Supportive Text23 1 Anterolateral, anteroposterior, anterior-left infra-23 2 A 2024 ILCOR scoping review identified 3 stud-23 CPR Before Defibrillation in Adult Cardiac Arrest24 Recommendation-Specific Supportive Text24 1 High-quality CPR is the single most critical inter-24 2 When VF/pVT has been present for more than a24 few minutes, myocardial reserves of oxygen and24 REFERENCES24 11 Connell PN, Ewy GA, Dahl CF, Ewy MD. Transthoracic impedance to defibril-25 ADULT FBAO25 Relief of FBAO in Conscious Adult Patients25 1 B-NR25 1 C-EO25 Recommendation-Specific Supportive Text25 1 There are no RCTs comparing the efficacy or25 2 Previous observational studies have demonstrated26 Relief of FBAO in Unconscious Adult Patients26 1 C-LD26 1 C-EO26 Recommendation-Specific Supportive Text26 1 Once a patient is unconscious, observational26 2 Removal of a visible foreign body will help to26 Relief of FBAO in Special Circumstances26 1 C-EO26 REFERENCES26 5 Dunne CL, Cirone J, Blanchard IE, Holroyd-Leduc J, Wilson TA, Sauro27 CARDIAC ARREST IN ADULT PATIENTS WITH OBESITY27 1 C-LD27 Synopsis27 Recommendation-Specific Supportive Text27 1 A 2024 ILCOR scoping review included 34 obser-27 2 Firm surfaces improve the likelihood of adequate27 4 Use of a partial backboard (or “CPR board”) in27 REFERENCES27 ALTERNATIVE TECHNIQUES FOR CPR IN ADULT CARDIAC ARREST28 Synopsis28 Recommendation-Specific Supportive Text28 1 Individual emergency medical response agencies28 3 Limited observational studies showed improved28 duration of chest compression cycles and no difference in chest compression depth when28 REFERENCES29 8 Nasiri E, Nasiri R. A comparison between over-the-head and lateral cardio-29 ARTICLE INFORMATION29 Disclosures30
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