Return of spontaneous circulation

And then ideally you get a return of circulation.

We call it ROSC, return of spontaneous circulation, and you pat yourself on the back and they go off to the ICU and that's a good code.

But then Not infrequently, you do not, and you do this, you try and try and try, and eventually you just have to call it, right? Okay, like, we're done.

And you stop CPR, and the patient's dead, except...

that? No, it's a good story.

Like doing cardiac arrest, doing CPR, it's called ROSC.

Yeah.

Coming back to, I've had several people that walked out of the hospital after cardiac arrest.

but the lungs absorb only about a quarter of this per breath meaning that exhaled breath contains more than enough oxygen to sustain life currently the american heart association cpr guidelines recommend 30 full chest compressions followed by two rescue breaths although as we'll get into shortly research indicates outcomes are significantly improved by having individuals skip the breaths altogether and sticking strictly to compressions only until professional help arrives in any event amusingly in order to maintain the recommended rhythm of around 100 chest compressions per minute the aha recommends that rescuers hum songs like the bg's staying alive queens another one bites the dust or the clashes should i stay or should i go less amusingly in order to adequately compress the heart through the rib cage the aha also recommends compressing the chest as much as two to three inches thus real life cpr is far less clean and tidy than depicted in films and tv often resulting in broken ribs and other painful injuries still there's a small price to pay for potentially staying alive and if things go the other way well you're not going to care anyway are you as previously noted while combined chest compressions and rescue breathing have been part of the aha's guidelines since their introduction in 1974 More recent research suggests the rescue breathing component may in fact be counterproductive and that chest compressions alone may actually give a higher chance of survival than traditional CPR.

For example, according to a 2008 study by Dr. Gordon Yui of the University of Arizona College of Medicine, survival rates for victims of out-hospital cardiac arrests receiving traditional cpr have remained consistently low for nearly 50 years compression-only cpr known as cardio-cerebral resuscitation or ccr has been shown to improve these odds by up to 300 but how can this be shouldn't rescue breathing improve the oxygenation of the blood and the survival of the brain well according to ui artificial respiration also increases air pressure in the chest cavity compressing blood vessels and reducing overall blood circulation chest compressions alone by contrast compress the lungs efficiently to adequately oxygenate the blood while simultaneously maintaining blood circulation which if stopping for breaths both stops the circulation and it takes several compressions to build the pressure and circulation back up after extending the blood flow interruption every breath But, whichever method is used, CPR is only intended to maintain the patient's circulation and stave off permanent brain damage until the heart can be restarted, a condition known in emergency medicine as return of spontaneous circulation, or ROSC.

While it is possible for this to occur due to the CPR itself, this is vanishingly rare, and ROSC is usually achieved naturally or through the use of various drugs.

The most common drug used in resuscitation is the hormone epinephrine or adrenaline, which, as previously mentioned, directly stimulates the sinoatrial nerve and increases heart rate.

The neurotransmitter dopamine and the alkaloid atrabine derived from the deadly nightshade plant are sometimes used for this purpose.

So, yeah.

So, and then at the end of the event, we have a little form that you can fill in online that says what you did, whether ROSC was obtained at that point or those kind of things.

And then there's some feedback elements.

And if you need welfare checks or anything like that, it can all come through that.