For Victims of Cardiovascular Events, Think C-A-B

After the Cardiac Arrest. The recommendations don’t stop when the patient regains spontaneous circulation. An entire section of the document is devoted to post–cardiac arrest care, pushing for an integrated, multidisciplinary approach. “Patients with suspected acute coronary syndrome should be triaged to a facility with reperfusion capabilities and a multidisciplinary team prepared to monitor patients for multi-organ dysfunction and initiate appropriate post–cardiac arrest therapy, including hypothermia.”

The guidelines deal with stroke separately, summarizing what should occur during out-of-hospital care through the first hours of therapy. One new recommendation is that acute stroke patients be triaged to a stroke center or dedicated stroke unit within 3 hours of presentation. The guidelines also expand the time window for administration of recombinant tissue plasminogen activator, and recommend it also be used in patients with acute ischemic stroke.

Many of the 33 writing members of the guidelines committee disclosed financial relationships, which are listed on the last page of the executive summary (Circulation 2010;122:S640-56).