Immediate management

• active compression-decompression cardiopulmonary resuscitation ^a
• adrenaline ^{a b}
• amiodarone  ^a
• vasopressin  ^a
• atropine for brady-asystolic arrest ^{b d}
• external pacing for asystole or pulseless electrical activity ^d
• calcium chloride ^{b d}
• buffer therapy ^{b d}
• magnesium ^d
• bretylium sulphate ^{b d}
• lignocaine ^b
• pneumatic trousers ^d
• calcium antagonists (e.g. lidoflazine ^d or nimodipine)  ^d

Why?

• Active compression-decompression cardiopulmonary resuscitation compared with standard manual resuscitation does not increase resuscitation success or survival. ^a
• Atropine, ^{b d} , pneumatic trousers ^d , magnesium, ^d and buffer therapy ^{b d} have no clear effect on resuscitation or survival
• Bretylium sulphate increases admission to hospital, but has no clear effect on survival to discharge ^{b d}
• Calcium chloride ^d and external pacing ^d have no effect on resuscitation in refractory asystole or pulseless electrical activity.