However, the injured cells do not actually die until hours after resuscitation.

This means that no resuscitation efforts are made, and a physician or nurse may pronounce legal death at the onset of clinical death.

The major source for ACLS courses and textbooks in the United States is the American Heart Association in Europe, it is the European Resuscitation Council (ERC).

In 1992, the European Resuscitation Council adopted a new position where the arm nearest the floor was brought out in front of the patient, whereas it had previously been placed behind the patient.

In 1990, the laboratory of resuscitation pioneer Peter Safar discovered that reducing body temperature by three degrees Celsius after restarting blood circulation could double the time window of recovery from clinical death without brain damage from 5 minutes to 10 minutes.

Patients are recommended for transplant if they have an arterial blood pH less than 7.3 after fluid resuscitation or if a patient has Grade III or IV encephalopathy, a prothrombin time greater than 100 seconds, and a serum creatinine greater than 300 mmol L In a 24 hour period.