The chest compression rate was increased and was unified to 100 times per minute for both adults and children. In the guidelines 2000, chest compression was more highlighted than rescue breathing. These two skills have been part of the CPR procedures since the beginning ( Trubuhovich, 2006). The chief aspects of CPR procedure were chest compression and mouth-to-mouth breathing (rescue breathing). If anyone of these links broke, the survival rate was greatly reduced even with advanced treatments in a hospital such as intubation or epinephrine injection ( Cummins et al., 1991). Therefore, the role of the layperson was quite important in a CPR situation. The first three links were the responsibilities of the layperson since several minutes are needed until emergency medical technicians arrive and can attend to the victim. The provision of subsequent CPR was strongly related to survival rate. Layperson (a witness) had to recognize a victim that passed out and had to make a phone call to the emergency system (911). It consisted of four links (a) early access (emergency call), (b) early CPR, (c) early defibrillation (an electric shock to the victim), and (d) early advanced CPR (in-hospital treatment). The concept of “Chain of Survival” has emerged as a way for higher potential survival rates in patients suffering from CA ( American Heart Association, International Liaison Committee on Resuscitation, 2000b). In other words, there were four levels of classification (a) definitely recommended, (b) good to very good recommended, (c) fair to good recommended, (d) may be harmful. The “level of evidence” classified each skill of CPR by the results. It was used as a basis for the next guidelines, “evidence-based resuscitation guidelines”, in which updates were supported by the results of resuscitation studies. The guidelines 2000 was meaningful in itself as the first unified international recommendation for CPR ( American Heart Association, International Liaison Committee on Resuscitation, 2000a). This paper will be helpful in understanding the latest methods and the highlights of CPR. The author mainly identified the purpose of these changes by examining the guidelines. This paper aims to investigate the changes made in the CPR guidelines from 2000 to the present. Several basics in physiologic fundamentals and maneuvers of CPR have changed. The international CPR guidelines have been revised 3 times since 2000, and the latest one was presented in 2015. Accordingly, there have been many reports of people who received CPR training successfully resuscitating victims. Laypersons are trained globally with basic guidelines in order for the trainees to be able to act as lifesavers. The guidelines have basic contents for laypersons as well as advanced contents for healthcare providers ( Kleinman et al., 2015 Link et al., 2015). Furthermore, the renewal of the guidelines has been announced every 5 years since 2000. The guidelines are the basis of most currently existing CPR methods that are being used in in-hospital or out-of-hospital circumstances. After 8 years, ILCOR created the “International Guidelines 2000 for CPR & ECC (emergency cardiovascular care)”, which became the cornerstone that standardized various CPR methods worldwide. These two societies formed the International Liaison Committee on Resuscitation (ILCOR) for the development of international guidelines in 1992. After that, two prominent societies, the American Heart Association in the US and the European Resuscitation Council in Europe have improved their own CPR guidelines respectively. The American Academy of Science made the first guidelines for CPR in 1966 ( Ad Hoc Committee on Cardiopulmonary Resuscitation, 1966). The current methods of CPR were based on the ones formed in the 1950s. They have started rescuing drowned people in Amsterdam and saved 150 victims since the past 4 years ( Trubuhovich, 2006). In 1767, the first rescue organization named “Amsterdam Rescue Society” has been established in the Netherlands ( Bierens, 2017). Resuscitation Medicine in the field of Emergency Medicine has developed for hundreds of years. The definition of CPR is a skill that can revive the human body when the process of death begins. So far, the only way to save a victim suffering from CA is cardiopulmonary resuscitation (CPR). Many people who experience CA eventually die however, for survivors of CA, familial or social supports such as rehabilitations are provided because of the neurologic sequelae which can result from hypoxic brain damage ( Boyce et al., 2019). In about 5 min after cessation of heartbeat, irrespective of its causes, brain cells start to deteriorate dramatically ( Safar, 1986). The major cause of cardiac arrest (CA) is cardiovascular in origin, and more often than not, it is unpredictable.
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