Resp Care
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The development of the AHA Guidelines for CPR and ECC and the AARC RACH Clinical Practice Guideline should both be instrumental in improving the performance of RCPs on in-hospital resuscitation teams. The AARC and AHA are assuming important leadership roles in this movement by publishing CPGs for CPR and ECC. RCPs with ACLS training are in a prime position to assume more responsibility on resuscitation teams within acute care facilities. ⋯ Successful CPR outcome should be carefully defined using the patient's disease category. Each patient should be individually evaluated for DNR orders. As suggested by Schwenzer, "Patients' perception of their quality of life before and after CPR should guide their and our decisions." However, we must all accept the responsibility for defining the limitations of medical technology and try to determine when CPR is futile.
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Existing guidelines for equipment and personnel have been described. In addition, the ASA guidelines on management of the difficult airway have been presented as an example of the type of algorithm that might be used for management of the difficult airway. Whereas guidelines are not standards, it is important to recognize that as guidelines are adopted by more and more practitioners, they become "standards of care" to which we are all held accountable.