Resuscitation - Overview
This chapter summarises the core clinical priorities, practical steps and system issues for adult in‑hospital resuscitation in the emergency department resuscitation room.
It is structured around the Resuscitation Council UK Advanced Life Support (ALS) framework as the primary clinical backbone and integrates ED‑specific operational guidance (RCEM), basic/initial life support expectations (RCUK BLS/ILS), and key NICE/GOV.UK policy points for post‑resuscitation care and DNACPR governance.
The content focuses on what you must do and why, with exam‑relevant emphasis on ALS priorities, reversible causes, special situations and handover/ethical considerations.
Scope
- In‑hospital adult cardiac arrest in the ED resuscitation area, including initial response, ALS, selected special situations (trauma, hypothermia, refractory arrest) and immediate post‑ROSC care.
- Primary algorithmic reference: Resuscitation Council UK - Adult ALS; use this for specific algorithms and drug timing.
- Complementary guidance: RCUK BLS/ILS, RCEM traumatic arrest guidance, NICE temperature‑control and ECPR guidance, and GOV.UK DNACPR policy.
Key clinical priorities (the ALS backbone) Resuscitation decisions and task sequencing in the resus room are driven by a small set of evidence‑based priorities:
- Deliver high‑quality chest compressions with correct rate and depth, full recoil and minimised pauses; the team leader must protect hands‑on time.
- Provide early, effective defibrillation for shockable rhythms and resume CPR immediately after a single shock; do not stack shocks.
- Identify and treat reversible causes promptly while CPR...