Immediate management

• interposed abdominal counterpulsation (compression over the umbilicus to co-ordinate with early relaxation of chest compression (rate 80 to 100 per minute)  ^a

Why?

• More patients are resuscitated and survive if given interposed abdominal counterpulsation compared with standard CPR ^a

Interposed abdominal counterpulsation saves lives

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
cardiac arrest a	interposed abdominal counterpulsation	standard CPR	return of spontaneous circulation at 3 minutes	26%	137% (43% to 294%)	3 (2 to 6)
			survival at 24 hours	13%	162% (18% to 483%)	5 (3 to 22)
			survival at discharge	7.2%	244% (19% to 895%)	6 (3 to 27)