CPADS-30: Mastering the first 30 seconds of adult cardiac arrest resuscitation.

backgroundAdvanced Cardiovascular Life Support (ACLS) knowledge and skills retention is poor among clinicians. Deviations from ACLS guidelines are common and are associated with worse outcomes and less experienced code leaders often feel unprepared to lead resuscitations.

objectiveTo develop a schematic for assisting code leaders in managing the initial phase of cardiac arrest resuscitations.

methodsWe reviewed the medical literature evaluating the effectiveness and timing of ACLS interventions in adult cardiac arrest, with a focus on identifying tasks most strongly associated with patient-centered outcomes and those most closely aligned with existing ACLS protocols. Four clinical content experts assessed the literature and independently ranked tasks to be included in the mnemonic; the final ranked list was approved by consensus discussion. We then incorporated our ranked list into a mnemonic using principles of cognitive load theory, including chunking, serial recall, and the primacy effect.

resultsWe identified five early interventions with strong evidence supporting their impact on outcomes. These interventions form the core of "CPADS-30", a simplified mnemonic designed to facilitate memory recall and facilitate task delegation in the first 30 s of cardiac arrest resuscitation. These tasks include C (Chest compressions), P (Pad [defibrillator] placement), A (Access [intravenous/intraosseous]), D (Drug administration) and S (Scribe assignment).

conclusion"CPADS-30" distills down critical early actions of cardiac arrest management into a discreet, digestible schematic that complements the complete ACLS algorithm. We hope "CPADS-30" will prove useful to trainees and providers of all levels of training in various practice environments.