CPR Indications and Contraindications

Cardiopulmonary resuscitation (CPR) can be understood in two ways: broadly and narrowly. The broad definition refers to modern CPR techniques, which include basic life support, advanced life support, and prolonged life support. The narrow definition specifically refers to manual CPR performed without equipment during basic life support. When people commonly refer to CPR, they usually mean the narrow definition. However, this article will primarily discuss the indications and contraindications of CPR in the broader sense.

Indications for CPR

Cardiopulmonary resuscitation is primarily indicated for cardiac arrest caused by various factors. These causes can be broadly categorized into cardiac and non-cardiac origins.

Cardiac Causes

Heart-related conditions are among the most common causes of cardiac arrest. Examples include acute myocardial infarction (heart attack), myocarditis, valvular heart disease, and various types of arrhythmias. In these situations, immediate CPR is crucial to restore circulation and increase the chances of survival.

Non-Cardiac Causes

Non-cardiac causes can also lead to cardiac arrest and require prompt CPR intervention. These include conditions such as hyperkalemia (high potassium levels), traumatic injuries, suffocation, cerebrovascular accidents (stroke), electrocution, and drowning. In such cases, addressing the underlying cause while performing CPR is essential for effective resuscitation.

Contraindications for CPR

There are no absolute contraindications for CPR. However, certain relative contraindications may exist, including open chest wall injuries, rib fractures, thoracic deformities, and cardiac tamponade. Additionally, patients with confirmed irreversible failure of critical organs such as the heart, lungs, or brain may not benefit from CPR.

Understanding Relative Contraindications

In clinical practice, contraindications are considered to avoid unnecessary harm, such as adverse drug reactions or complications from chest compressions. However, when a patient is in a life-threatening condition requiring CPR, the priority is to save their life. Even in the presence of contraindications, resuscitation efforts are often initiated due to the urgency of the situation. It is important to note that in patients with severe underlying diseases, the success rate of CPR may be lower, and clinical judgment must be exercised when deciding on resuscitation strategies.