UMEM Educational Pearls

Category: Cardiology

Title: cardiocerebral resuscitation

Posted: 5/10/2009 by Amal Mattu, MD (Updated: 12/1/2023)
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Cardiocerebral resuscitation is a new approach to CPR which has demonstrated improvements in survival and neurological recovery. The main focus is early defibrillation and good compressions with an early dose of EPI, but with a strong de-emphasis on early intubation or bagging. Most patients with sudden cardiac arrest don't need early oxygenation anyway, and the previous emphasis on ventilations only serves to take time and effort away from the important chest compressions. Intubation is deferred for 6-8 minutes after the cardiac arrest in favor of simple passive oxygenation with a non-rebreather.

The bottom line is that when facing a patient in cardiac arrest, the traditional mantra in emergency medicine of "A-B-C" needs to now be changed to emphasize the "C" coming first, second, and third.


Kellum MJ, et al. Cardiocerebral resuscitation improves neurologically intact survival of patients with out-of-hosptial cardiac arrest. Ann Emerg Med 2008;52:244-252.