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In Reply: We look forward to the final recommendations from the ILCOR/AHA ECC Committee. In our Editorial, we noted that with each update of the guidelines, ECC/advanced cardiac life support training has become progressively more complex. We hope that the new guidelines will be simpler. We recommend that ECC return to a primary focus on cardiac arrest and consider eliminating elaborate guidelines for other cardiovascular conditions such as acute myocardial infarction, stroke, arrhythmias, and pulmonary edema. In this way, the ECC guidelines for CPR could be updated more frequently.

To move off the plateau of a very low survival rate following cardiac arrest, more than just minor changes in the guidelines are required. Changing the compression-ventilation ratio or training rescuers to minimize interruptions in chest compressions will not accomplish the goal. Individuals unwilling to perform chest compressions with mouth-to-mouth resuscitation at a 2:15 ratio (most people) are not likely to . . . [Full Text of this Article]

Arthur B. Sanders, MD
Department of Emergency Medicine
University of Arizona College of Medicine

Gordon A. Ewy, MD
University of Arizona Sarver Heart Center
Tucson

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