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GENERAL CARDIOLOGY
Minimally interrupted cardiac resuscitation (MICR) is a new approach to out-of-hospital cardiac arrest that focuses on maximising myocardial and cerebral perfusion through a series of coordinated interventions. It is designed to minimise the interruption of chest compressions, provide immediate pre-shock chest compressions for prolonged ventricular fibrillation, delay or eliminate endotracheal intubation, minimise positive pressure ventilations and decrease the time interval to intravenous adrenaline administration. More specifically, the approach involves an initial series of 200 uninterrupted chest compressions, followed by a rhythm analysis with a single shock only, then 200 immediate post-shock chest compressions before pulse check or rhythm analysis, early administration of adrenaline and delayed endotracheal intubation.
Bobrow et al investigated whether this technique might be used to improve survival in patients with an out-of-hospital arrest in Arizona, USA. They designed a prospective study of survival-to-hospital discharge that was conducted over a 34-month period. First, patient outcomes were assessed before
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