scholarly journals Сardiopulmonary and cerebral resuscitation: new European Resuscitation Council Guidelines for resuscitation 2021

2021 ◽  
Vol 17 (8) ◽  
pp. 6-19
Author(s):  
L.V. Usenko ◽  
А.V. Tsarev ◽  
Yu.Yu. Kobelatsky
Keyword(s):  
Cardiac Arrest ◽  
Healthcare Workers ◽  
Basic Life Support ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Advanced Life Support ◽  
European Resuscitation Council ◽  
Improved Outcomes ◽  
Electrical Defibrillation

The article presents the current changes in the algorithm of cardiopulmonary and cerebral resuscitation (CPCR), adopted by the European Council for Resuscitation in 2021. The article presents the principles of basic life support and advanced life support, inclu-ding taking into account the European recommendations published in 2020, dedicated to the specifics of CPCR in the context of the COVID-19 pandemic. The main focus of CPCR in the COVID-19 pandemic is that the safety of healthcare workers should never be compromised, based on the premise that the time it takes to ensure that care is delivered safely to rescuers is acceptable part of the CPCR process. The principles of electrical defibrillation, including in patients with coronavirus disease who are in the prone position, pharmacological support of CPCR, modern monitoring capabilities for assessing the quality of resuscitation measures and identifying potentially reversible causes of cardiac arrest, the use of extracorporeal life support techno-logies during CPR are highlighted. The modern principles of intensive care of the post-resuscitation syndrome are presented, which makes it possible to provide improved outcomes in patients after cardiac arrest.

Meta-analysis of the accuracy of termination of resuscitation rules for out-of-hospital cardiac arrest

2019 ◽  
Vol 36 (8) ◽  
pp. 479-484 ◽  
Author(s):  
Mark H Ebell ◽  
Akke Vellinga ◽  
Siobhan Masterson ◽  
Phillip Yun
Keyword(s):  
Cardiac Arrest ◽  
Basic Life Support ◽  
Life Support ◽  
Meta Analysis ◽  
Advanced Life Support ◽  
Study Quality ◽  
European Resuscitation Council ◽  
Comprehensive Search ◽  
Hospital Cardiac Arrest ◽  
Low Rate

BackgroundOur objective was to perform a systematic review of studies reporting the accuracy of termination of resuscitation rules (TORRs) for out-of-hospital cardiac arrest (OHCA).MethodsWe performed a comprehensive search of the literature for studies evaluating the accuracy of TORRs, with two investigators abstracting relevant data from each study regarding study design, study quality and the accuracy of the TORRs. Bivariate meta-analysis was performed using the mada procedure in R.ResultsWe identified 14 studies reporting the performance of 9 separate TORRs. The sensitivity (proportion of eventual survivors for whom the TORR recommends resuscitation and transport) was generally high: 95% for the European Resuscitation Council (ERC) TORR, 97% for the basic life support (BLS) TORR and 99% for the advanced life support (ALS) TORR. The BLS and ERC TORR were more specific, which would lead to fewer futile transports, and all three of these TORRs had a miss rate of ≤0.13% (defined as a case where a patient is recommended for termination but survives). The pooled proportion of patients for whom each rule recommends TOR was much higher for the ERC and BLS TORRs (93.5% and 74.8%, respectively) than for the ALS TORR (29.0%).ConclusionsThe BLS and ERC TORRs identify a large proportion of patients who are candidates for termination of resuscitation following OHCA while having a very low rate of misclassifying eventual survivors (<0.1%). Further prospective validation of the ERC TORR and direct comparison with BLS TORR are needed.

scholarly journals Interim Singapore guidelines for basic and advanced life support for paediatric patients with suspected or confirmed COVID-19

2021 ◽  
Author(s):  
GY Ong ◽  
BHZ Ng ◽  
YH Mok ◽  
JSM Ong ◽  
N Ngiam ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Best Practices ◽  
Healthcare Workers ◽  
Life Support ◽  
Advanced Life Support ◽  
First Aid ◽  
Local Context ◽  
Paediatric Patients ◽  
Improved Outcomes ◽  
Paediatric Cardiac Arrest

The COVID-19 pandemic has resulted in significant challenges for the resuscitation of paediatric patients, especially for infants and children who are suspected or confirmed to be infected. Thus, the paediatric subcommittee of the Singapore Resuscitation and First Aid Council developed interim modifications to the current Singapore paediatric guidelines using extrapolated data from the available literature, local multidisciplinary expert consensus and institutional best practices. It is hoped that this it will provide a framework during the pandemic for improved outcomes in paediatric cardiac arrest patients in the local context, while taking into consideration the safety of all community first responders, medical frontline providers and healthcare workers.

scholarly journals Survival and quality of life after extracorporeal life support for refractory cardiac arrest: A case series

2015 ◽  
Vol 150 (4) ◽  
pp. 947-954 ◽  
Author(s):  
Amedeo Anselmi ◽  
Erwan Flécher ◽  
Hervé Corbineau ◽  
Thierry Langanay ◽  
Vincent Le Bouquin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Case Series ◽  
Refractory Cardiac Arrest

Resuscitation on the field: basic and advanced life support and automatic external defibrillators

2019 ◽  
pp. 403-410
Author(s):  
Mark S. Link ◽  
Mark Estes III
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Basic Life Support ◽  
Life Support ◽  
Action Plan ◽  
Advanced Life Support ◽  
Advanced Cardiac Life Support ◽  
Screening Strategy ◽  
Automated External Defibrillators ◽  
Playing Field

Resuscitation on the playing field is at least as important as screening in the prevention of death. Even if a screening strategy is largely effective, individuals will suffer sudden cardiac arrests. Timely recognition of a cardiac arrest with rapid implementation of cardiopulmonary resuscitation (CPR) and deployment and use of automated external defibrillators (AEDs) will save lives. Basic life support, including CPR and AED use, should be a requirement for all those involved in sports, including athletes. An emergency action plan is important in order to render advanced cardiac life support and arrange for transport to medical centres.

Life-threatening emergencies

2012 ◽  
pp. 40-61
Author(s):  
Jonathan P. Wyatt ◽  
Robin N. Illingworth ◽  
Colin A. Graham ◽  
Kerstin Hogg ◽  
Michael J. Clancy ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Basic Life Support ◽  
Life Support ◽  
Central Venous Access ◽  
Treatment Algorithm ◽  
Advanced Life Support ◽  
Venous Access ◽  
Central Venous ◽  
Life Threatening

Anaphylaxis 42 Treatment algorithm for adults with anaphylaxis 44 Choking 45 Cardiac arrest 46 In-hospital resuscitation algorithm 47 Adult basic life support 48 Cardiac arrest management 50 Advanced life support algorithm 52 Notes on using the advanced life support algorithm 53 Post-resuscitation care 54 Central venous access ...

scholarly journals Factors affecting survival after prehospital asystolic cardiac arrest in a Basic Life Support-Defibrillation system

CJEM ◽  
2001 ◽  
Vol 3 (03) ◽  
pp. 186-192 ◽  
Author(s):  
David A. Petrie ◽  
Valerie De Maio ◽  
Ian G. Stiell ◽  
Jonathan Dreyer ◽  
Michael Martin ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Survival Rate ◽  
Basic Life Support ◽  
Life Support ◽  
Ethical Decision Making ◽  
Pulseless Electrical Activity ◽  
Advanced Life Support ◽  
Stepwise Logistic Regression ◽  
Bystander Cpr

ABSTRACT Objectives: Previous studies have shown a low but meaningful survival rate in cases of prehospital cardiac arrest with an initial rhythm of asystole. There may be, however, an identifiable subgroup in which resuscitation efforts are futile. This study identified potential field criteria for predicting 100% nonsurvival when the presenting rhythm is asystole in a Basic Life Support-Defibrillation (BLS-D) system. Methods: This prospective cohort study, a component of Phases I and II of the Ontario Prehospital Advanced Life Support (OPALS) Study, was conducted in 21 Ontario communities with BLS-D level of care, and included all adult arrests of presumed cardiac etiology according to the Utstein Style Guidelines. Analyses included descriptive and appropriate univariate tests, as well as multivariate stepwise logistic regression to determine predictors of survival. Results: From 1991 to 1997, 9899 consecutive cardiac arrest cases with the following characteristics: male (67.2%), bystander-witnessed (44.7%), bystander CPR (14.2%), call–response interval (CRI) ≤ 8 minutes (82%) and overall survival (4.3%) were enrolled. Of 9529 cases with available rhythm strip recordings, initial arrest rhythms were asystole in 40.8%, pulseless electrical activity in 21.2% and ventricular fibrillation or ventricular tachycardia in 38%. Of 3888 asystolic patients, 9 (0.2%) survived to discharge; 3 of these cases were unwitnessed arrests with no bystander CPR. There were no survivors if the CRI exceeded 8 minutes. Logistic regression analysis demonstrated that independent predictors of survival to admission were “CRI in minutes” (odds ratio [OR] = 0.87; 95% confidence interval [CI], 0.77–0.98) and “bystander-witnessed” (OR = 2.6; 95% CI, 1.5–4.4). Conclusions: In a BLS-D system, there is a very low but measurable survival rate for prehospital asystolic cardiac arrest. CRIs of over 8 minutes were associated with 100% nonsurvival, whereas unwitnessed arrests with no bystander CPR were not. These data add to the growing literature that will help guide ethical decision-making for protocol development in emergency medical services systems.

Abstract 146: Evaluation of Out-of-hospital Ventricular Fibrillation Cardiac Arrest Management, With a Simulation Method

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Cécile Ursat ◽  
Guillaume Douge ◽  
Charles Groizard ◽  
Anna Ozguler ◽  
Michel Baer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Advanced Life Support ◽  
Simulation Method ◽  
Quality Parameters ◽  
Real Patient ◽  
Decision Algorithm ◽  
St Segment Elevation ◽  
Monitoring Devices

Introduction: Feed-back on quality of CPR is an important aspect to consider on cardiac arrest management. This has been pointed out during trainings organized for emergency medicine residents. In parallel, RéAC registry (registry on cardiac arrests in France) showed some difficulties in following guidelines of VF.The aim of this study was to evaluate the performance of Emergency Medical Service (EMS) in the management of patients in cardiac arrest through the use of external chest compression (CC) data from the Resusci Anne Simulator manikin from Laerdal (SimMan®), equipped with SimPad SkillReporter. Methodology: During 2nd to 6th of March 2015, 18 EMS teams (1 physician, 1 paramedic and 1 nurse) were asked to manage a VF on a Resusci Anne Simulator manikin. This allowed the direct measurement of CC quality parameters and the evaluation of decision algorithm, through the use of a same scenario. The scenario was introduced to each team at the beginning of each session. At first, the “patient” was still conscious, on a stretcher and had a ST-segment elevation myocardial infarction. While the patient was installed in the ambulance, he suddenly had a FV cardiac arrest that could be detected on monitoring devices (time 0 of simulation). VF lasted for 10 minutes, followed by 5 minutes of asystole. The manikin software displayed the different parameters as the scenario progressed. The simulation was performed on a stretcher in an EMS premise, with the same equipment and monitoring devices as in an advanced life support ambulance (ALS). Results: CC were performed 71% of CPR time. CC depth was considered as non-compliant to guidelines in 28% of cases, with a mean depth of 4.4 cm, compressions with complete release in 37% of cases. Mean compression rate was 122/minute and was correct in 49% of cases. One third used Amiodarone after the third shock. 13/18 teams resumed chest compressions immediately after defibrillation attempts. Conclusion: This study shows the difficulty to strictly follow guidelines. According to participants, the massage was considered as more difficult with a manikin rather than on a real patient. Although cardiac arrest occurring during transportation is quite rare, quality of CPR at pre-hospital level should be improved.

Out-of-hospital cardiac arrest

2021 ◽  
pp. 76-87
Author(s):  
Jerry P Nolan ◽  
Christian Hassager
Keyword(s):  
Cardiac Arrest ◽  
Basic Life Support ◽  
Life Support ◽  
Spontaneous Circulation ◽  
Neurological Injury ◽  
Shockable Rhythm ◽  
Initial Rhythm ◽  
Medical Emergencies ◽  
Hospital Cardiac Arrest

Cardiac arrest is the most extreme of medical emergencies. If the victim is to have any chance of high-quality neurological recovery, cardiac arrest must be diagnosed quickly, followed by summoning for help as basic life support (chest compressions and ventilations) is started. In most cases, the initial rhythm will be shockable, but this will have often deteriorated to a non-shockable rhythm by the time a monitor and/or defibrillator is applied. While basic life support will sustain some oxygen delivery to the heart and brain and will help to slow the rate of deterioration in these vital organs, it is important to achieve restoration of a spontaneous circulation as soon as possible (by defibrillation if the rhythm is shockable). Once return of spontaneous circulation is achieved, the quality of post-cardiac arrest management will influence the patient's final neurological and cardiological outcome. These interventions aim to restore myocardial function and minimize neurological injury.

scholarly journals New insights for adult cardiopulmonary resuscitation. Up-coming resuscitation guidelines 2010

Medicina ◽  
2010 ◽  
Vol 46 (9) ◽  
pp. 571 ◽  
Author(s):  
Andrius Pranskūnas ◽  
Paulius Dobožinskas ◽  
Vidas Pilvinis ◽  
Živilė Petkevičiūtė ◽  
Nedas Jasinskas ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Survival Rates ◽  
Advanced Life Support ◽  
Current Trends ◽  
Resuscitation Guidelines ◽  
Chain Of Survival ◽  
Meta Analyses

Despite advances in cardiac arrest care, the overall survival to hospital discharge remains poor. The objective of this paper was to review the innovations in cardiopulmonary resuscitation that could influence survival or change our understanding about cardiopulmonary resuscitation. We have performed a search in the MEDLINE and the Cochrane databases for randomized controlled trials, meta-analyses, expert reviews from December 2005 to March 2010 using the terms cardiac arrest, basic life support, and advanced life support. The lack of randomized trials during the last 5 years remains the main problem for crucial decisions in cardiopulmonary resuscitation. Current trends in cardiopulmonary resuscitation are toward minimizing the interruptions of chest compressions and improving the quality of cardiopulmonary resuscitation. In addition, attention should be paid to all the parts of chain of survival, which remains essential in improving survival rates.

scholarly journals Out-of-hospital cardiac arrest: determinant factors for immediate survival after cardiopulmonary resuscitation

2014 ◽  
Vol 22 (4) ◽  
pp. 562-568 ◽  
Author(s):  
Daniela Aparecida Morais ◽  
Daclé Vilma Carvalho ◽  
Allana dos Reis Correa
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Basic Life Support ◽  
Life Support ◽  
Advanced Life Support ◽  
Medical Services ◽  
Determinant Factors ◽  
Emergency Medical ◽  
Advanced Support

OBJECTIVE: to analyze determinant factors for the immediate survival of persons who receive cardiopulmonary resuscitation from the advanced support units of the Mobile Emergency Medical Services (SAMU) of Belo Horizonte.METHOD: this is a retrospective, epidemiological study which analyzed 1,165 assistance forms, from the period 2008 - 2010. The collected data followed the Utstein style, being submitted to descriptive and analytical statistics with tests with levels of significance of 5%.RESULTS: the majority were male, the median age was 64 years, and the ambulance response time, nine minutes. Immediate survival was observed in 239 persons. An association was ascertained of this outcome with "cardiac arrest witnessed by persons trained in basic life support" (OR=3.49; p<0.05; CI 95%), "cardiac arrest witnessed by Mobile Emergency Medical Services teams" (OR=2.99; p<0.05; CI95%), "only the carry out of basic life support" (OR=0.142; p<0.05; CI95%), and "initial cardiac rhythm of asystole" (OR=0.33; p<0.05; CI 95%).CONCLUSION: early access to cardiopulmonary resuscitation was related to a favorable outcome, and the non-undertaking of advanced support, and asystole, were associated with worse outcomes. Basic and advanced life support techniques can alter survival in the event of cardiac arrest.

Sign in / Sign up

Export Citation Format

Share Document