Tae-Youn Kim, Gyo Jin Ahn, Kyoung-Chul Cha, Dong-Hyeok Kim, Youdong Sohn, Young Song, Gyuhong Shim, Do Kyun Kim, Yunhee Oh, Jin Wi, Chun Song Youn, Myung-Lyeol Lee, Mi Jin Lee, Byung Kook Lee, Byung Heon Lee, Jisook Lee, Chang Hee Lee, Hannah Lee, Youngbin Jang, Yong Soo Jang, Young Hwa Jung, Woo Jin Jung, Sung Phil Chung, Gyu Chong Cho, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S61-S74. Published online May 31, 2026
The 2025 update of the Korean guidelines for cardiac arrest under special circumstances incorporates new evidence and expert consensus to clarify when clinicians should modify standard resuscitation algorithms. For cardiac arrest caused by acute hyperkalemia, the guidelines suggest administering intravenous insulin with glucose; however, current evidence remains insufficient to recommend for or against routine use of sodium bicarbonate or calcium. In suspected pulmonary embolism–related cardiac arrest, thrombolytic therapy may be considered. In confirmed cases, thrombolysis, surgical embolectomy, or percutaneous mechanical thrombectomy may be appropriate, despite very low certainty of evidence. For opioid-related cardiac arrest, current evidence does not support the routine administration of naloxone in addition to standard advanced life support; however, naloxone may be administered when it is unclear whether the patient is in true cardiac arrest. The guidelines also emphasize managing cardiac arrest in the prone position. If the patient is intubated and immediate repositioning is unsafe or impractical, prone cardiopulmonary resuscitation and defibrillation may be attempted using invasive arterial pressure or end-tidal carbon dioxide monitoring to guide the timing of repositioning. Immediate supination is strongly recommended for non-intubated patients. Additional updates address drowning, severe hypothermia, pregnancy, anaphylaxis, and cardiac arrest during interventional procedures, underscoring the importance of early correction of reversible causes, appropriate airway strategies, and timely consideration of extracorporeal life support in selected cases. Overall, the 2025 recommendations highlight cautious, etiology-directed interventions and explicitly grade recommendation strength and certainty to support context-sensitive clinical decision-making in high-risk and resource-variable settings.
Tae-Youn Kim, Gyo Jin Ahn, Kyoung-Chul Cha, Dong-Hyeok Kim, Youdong Sohn, Young Song, Gyuhong Shim, Do Kyun Kim, Yunhee Oh, Jin Wi, Chun Song Youn, Myung-Lyeol Lee, Mi Jin Lee, Byung Kook Lee, Byung Heon Lee, Jisook Lee, Chang Hee Lee, Hannah Lee, Youngbin Jang, Yong Soo Jang, Young Hwa Jung, Woo Jin Jung, Sung Phil Chung, Gyu Chong Cho, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S32-S60. Published online May 31, 2026
The 2025 Korean advanced life support guidelines were updated using a structured evidence evaluation process informed by recent randomized controlled trials and systematic reviews. The guideline development group prioritized patient-important outcomes and assessed the certainty of the evidence to formulate graded recommendations. For drug administration during adult cardiac arrest, intravenous access is the preferred initial route, with intraosseous access recommended when intravenous access cannot be rapidly established. Epinephrine remains the recommended vasopressor. Routine administration of vasopressin, either alone or in combination with corticosteroids, is not recommended for in-hospital or out-of-hospital cardiac arrest. In the absence of specific indications, the routine use of buffering agents and calcium is discouraged owing to insufficient evidence of their benefits and potential harm. Defibrillation recommendations were refined based on emerging evidence. In adults with refractory ventricular fibrillation or pulseless ventricular tachycardia after multiple unsuccessful defibrillation attempts, vector change or double sequential defibrillation may be considered in selected settings when performed by experienced teams with appropriate equipment. Airway management guidelines recommend cricothyroidotomy as a rescue technique when conventional airway management strategies fail. For patients receiving cardiopulmonary resuscitation while on mechanical ventilation, specific ventilator settings during chest compressions are recommended to optimize ventilation and minimize interference with high-quality cardiopulmonary resuscitation. The guidelines also address cardiopulmonary resuscitation–induced consciousness, allowing the cautious use of sedatives and/or analgesic agents when awareness interferes with resuscitation quality or safety. Overall, the guidelines emphasize evidence-based practice and individualized clinical decision-making.
Jaehoon Oh, Kyoung-Chul Cha, Jong-Hwan Lee, Seungmin Park, Dong-Hyeok Kim, Byung Kook Lee, Jung Soo Park, Sung Phil Chung, Young-Min Kim, June Dong Park, Han-Suk Kim, Mi Jin Lee, Sang-Hoon Na, Gyu Chong Cho, Ai-Rhan Ellen Kim, Sung Oh Hwang, Steering Committee of the 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Clin Exp Emerg Med 2022;9(2):162-163. Published online June 30, 2022
Jaehoon Oh, Kyoung-Chul Cha, Jong-Hwan Lee, Seungmin Park, Dong-Hyeok Kim, Byung Kook Lee, Jung Soo Park, Woo Jin Jung, Dong Keon Lee, Young Il Roh, Tae Youn Kim, Sung Phil Chung, Young-Min Kim, June Dong Park, Han-Suk Kim, Mi Jin Lee, Sang-Hoon Na, Gyu Chong Cho, Ai-Rhan Ellen Kim, Sung Oh Hwang, on behalf of the Steering Committee of the 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Clin Exp Emerg Med 2021;8(S):S26-S40. Published online May 21, 2021
Case Volume of Targeted Temperature Management and Neurological Outcomes in Comatose Out-of-Hospital Cardiac Arrest Survivors: Nationwide Population-Based Study Dongju Kim, Hanna Park, Hyojeong Kwon, Sang-Min Kim, June-Sung Kim, Youn-Jung Kim, Won Young Kim Korean Circulation Journal.2026; 56(6): 495. CrossRef
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Barriers to Point-of-Care Ultrasound Utilization Among Emergency Medicine Residents in Riyadh, Saudi Arabia Fahad Abuguyan, Naief W Almasry, Ali A Alzahrani Cureus.2024;[Epub] CrossRef
The role of blood nitric oxide level in predicting return of spontaneous circulation: a prospective case-control study Atıf Bayramoğlu, Erdal Tekin, Engin Kurt, Kamber Kaşali, Nezahat Kurt Revista da Associação Médica Brasileira.2024;[Epub] CrossRef
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Pre-arrest comorbidity burden and the future risk of out-of-hospital cardiac arrest in Korean adults Seok-In Hong, Youn-Jung Kim, Ye-Jee Kim, Won Young Kim Heart.2023; 109(7): 542. CrossRef
Extracorporeal cardiopulmonary resuscitation for adult out-of-hospital cardiac arrest patients: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry Yeongho Choi, Jeong Ho Park, Joo Jeong, Yu Jin Kim, Kyoung Jun Song, Sang Do Shin Critical Care.2023;[Epub] CrossRef
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Arterial Blood Gas Analysis for Survival Prediction in Pediatric Patients with Out-of-Hospital Cardiac Arrest Sang-Hwan Lee, Hyungoo Shin, Yongil Cho, Jaehoon Oh, Hyuk-Joong Choi Journal of Personalized Medicine.2023; 13(7): 1061. CrossRef
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Gastric Inflation in Prehospital Cardiopulmonary Resuscitation: Aspiration Pneumonia and Resuscitation Outcomes Tae Youn Kim, Soyeong Kim, Sang Il Han, Sung Oh Hwang, Woo Jin Jung, Young Il Roh, Kyoung-Chul Cha Reviews in Cardiovascular Medicine.2023;[Epub] CrossRef
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