Part 2: International Collaboration in Resuscitation Science 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Article · October 2010with10 Reads
DOI: 10.1161/CIRCULATIONAHA.110.970921 · Source: PubMed
    • 1962, direct current monophasic waveform defibrillation was described;[6]in 1966, the first guidelines for CPR were developed by American Heart Association (AHA). The International Liaison Committee on Resuscitation (ILCOR) was founded in 1992 to promote international collaboration with a goal of endorsing evidence-based resuscitation science that can be adopted by regional councils to formulate resuscitation guidelines.[7]Since then ILCOR has published more than 22 scientific advisory statements including 5 yearly advisory statements with thein the dental school curriculum.
    [Show abstract] [Hide abstract] ABSTRACT: Aim and Objetive: The burden of cardiac arrest remains enormous globally. Early recognition and prompt and effective cardiopulmonary resuscitation are crucial to successful outcome following a cardiac arrest. This study assessed the impact of basic life support (BLS) training on the knowledge of a group of dental students. Materials and Methods: Sixty-eight dental students participated in this interventional study. Using convenience sampling, pre- and post-BLS training assessment were conducted with a questionnaire. Results: The mean score (standard deviation) for pretest was 4.7 (±1.47) with a range of 2–8 out a total of 10, while the mean posttest score was 8.04 ± 1.47 with a range of 3–10. The differences were statistically significant ( P Conclusion: The results of this study suggest that the group of dental students' knowledge of BLS was very poor prior to the BLS training. The study also showed that the BLS training had a positive influence on the BLS knowledge of the participants.
    Full-text · Article · Jan 2015
    • This increased rate of bystander CPR has later been confirmed elsewhere [2,7,8]. T-CPR was strongly recommended by the International Liaison Committee on Resuscitation in 2010 [9], and reinforced by the American Heart Association in 2012 [10]. T-CPR might also improve CPR quality [11] , and good quality bystander CPR is associated with improved survival121314.
    [Show abstract] [Hide abstract] ABSTRACT: Background: Telephone-CPR (T-CPR) can increase rate of bystander CPR as well as CPR quality. Instructions for T-CPR were developed when most callers used a land line. Telephones today are often wireless and can be brought to the patient. They often have speaker function which further allows the rescuer to receive instructions while performing CPR.We wanted to measure adult lay people's ability to activate the speaker function on their own mobile phone. Methods: Elderly lay people, previously trained in CPR, were contacted by telephone. Participants with speaker function experience were asked to activate this without further instructions, while participants with no experience were given instructions on how to activate it. Participants were divided in three groups; Group 1: Can activate the speaker function without instruction, Group 2: Can activate the speaker function with instruction, and Group 3: Unable to activate the speaker function. Time to activation for group 1 and 2 was compared using Mann-Whitney U-test. Results: Seventy-two elderly lay people, mean age 68 ± 6 years participated in the study. Thirty-five (35)% of the participants were able to activate the speaker function without instructions, 29% with instructions and 36% were unable to activate the speaker function. The median time to activate the speaker function was 8s and 93s, with and without instructions, respectively (p < 0.01). Conclusion: One-third of the elderly could activate speaker function quickly, and two-third either used a long time or could not activate the function.
    Full-text · Article · May 2013
    • Therefore, to assess the factors influencing the outcome of CPR will help to evaluate the efficiency of resuscitation. Utstein-style definitions and reporting templates have been used while increasing effectively the clinical outcomes after resuscitation and making great progress toward international guidelines or consensus on resuscitation science.[5,6] In recent years, Utstein-style registering templates have been used clinically in a few domestic regions.[7–11]
    [Show abstract] [Hide abstract] ABSTRACT: BACKGROUND: The outcome of cardiopulmonary resuscitation (CPR) may depend on a variety of factors related to patient status or resuscitation management. To evaluate the factors influencing the outcome of CPR after cardiac arrest (CA) will be conducive to improve the effectiveness of resuscitation. Therefore, a study was designed to assess these factors in the emergency department (ED) of a city hospital. METHODS: A CPR registry conforming to the Utstein-style template was conducted in the ED of the First Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2011. The outcomes of CPR were compared in various factors groups. The primary outcomes were rated to return of spontaneous circulation (ROSC), 24-hour survival, survival to discharge and discharge with favorable neurological outcomes. Univariate analysis and multivariable logistic regression analysis were performed to evaluate factors associated with survival. RESULTS: A total of 725 patients were analyzed in the study. Of these patients, 187 (25.8%) had ROSC, 100 (13.8%) survived for 24 hours, 48 (6.6%) survived to discharge, and 23 (3.2%) survived to discharge with favorable neurologic outcomes. A logistic regression analysis demonstrated that the independent predictors of ROSC included traumatic etiology, first monitored rhythms, CPR duration, and total adrenaline dose. The independent predictors of 24-hour survival included traumatic etiology, cardiac etiology, first monitored rhythm and CPR duration. Previous status, cardiac etiology, first monitored rhythms and CPR duration were included in independent predictors of survival to discharge and neurologically favorable survival to discharge. CONCLUSIONS: Shockable rhythms, CPR duration ≤15 minutes and total adrenaline dose ≤5 mg were favorable predictors of ROSC, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms and CPR duration ≤15 minutes were favorable predictors of 24-hour survival, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms, CPR duration ≤15 minutes were favorable predictors of survival to discharge and neurologically favorable survival to discharge, but previous terminal illness or multiple organ failure (MOF) was unfavorable.
    Full-text · Article · Mar 2013
    • In particular , the AHA has adopted the CAB (compressions–airway–breathing ) approach that had been implemented by the ERC in 2005. Minor international differences in CPR practice are inevitable and the reasons for these have been elucidated in the 2010 consensus document [3]. What is the future for the international consensus on CPR science?
    Article · Nov 2010
    • Die biphasische Impulsform besteht aus zwei Phasen, einem positiven Anteil, der nach der Hälfte oder 2/3 der Impulsdauer endet und einem negativen Anteil, währenddessen die dann noch verbleibende Restenergie abgegeben wird. Tierexperimentelle Untersuchungen ergaben, dass der biphasische Schock mit höherer Ausgangsspannung und längerer Dauer der ersten Impulsabgabe günstiger war als biphasische Defibrillationsimpulse mit längerer und hochamplitudiger zweiter Phase [ [19]. Für den monophasischen Schock werden in Anbetracht der Unterlegenheit von Beginn an 360 Joule für jeden Schock vorgeschlagen.
    [Show abstract] [Hide abstract] ABSTRACT: Bradycardia (heart rate <50/min) (BR) and tachycardia rhythm disturbances (heart rate >100/min) (TR) require rapid and targeted therapeutic strategies. Supraventricular tachycardias (SVT) are paroxysmal forms of tachycardia, such as sinus tachycardia, atrial tachycardia, AV-nodal re-entry tachycardia and tachycardia due to accessory pathways. All SVTs are characterized by a ventricular heart rate >100/min and small QRS complexes (QRS width <0.12 s) during tachycardia. It is essential to evaluate the arrhythmia history and to perform a careful physical examination with exact analysis of the 12-lead electrocardiogram. An exact diagnosis of SVT is then possible in >90% of cases. Ventricular tachycardia (VT) has a broad QRS complex (QRS width ≥0.12 s), while ventricular flutter (VFlut) and ventricular fibrillation (VF) are associated with chaotic electrophysiologic findings. For acute therapy the new “5As” concept consisting of adenosine, adrenaline, ajmaline, amiodarone and atropine is presented. Additional “B, C and D strategies” are beta blocking agents, cardioversion and defibrillation. The 5As concept allows a safe and effective treatment of BR, TR, SVT, VT, VFlut, VF and asystole and together with the B, C and D strategies provides an effective treatment of all emergency situations due to arrhythmia.
    Article · Feb 2010
  • [Show abstract] [Hide abstract] ABSTRACT: Objective: Morphological myocardial tissue cytoarchitecture alterations after transthoracic countershocks were extensively studied. The aim of the present study was to evaluate the electrical discharge application effects to the atrium subcellular level. Methods: An electrical cardioverter was adapted to small rodent animals for this study. Electrical discharges were applied to the precordial region of 30 rats. Three groups with ten animals each were randomly constituted. Animals were divided into a control group - animals that remained on resting period and were afterwards sacrificed; an electrical discharge group - animals that remained on resting period, followed by ten electrical discharges of 300 mV and sacrificed; and an electrical post-discharge group - animals that stayed on a resting period and received ten electrical discharges like the electrical discharge group, but were sacrificed seven days subsequently. Liver, adrenal and left atrium tissue fragments of all groups were examined. Results: In the control and in the post-discharge groups a normal cellular structure aspect with preserved architecture of cardiomyocytes and continuous sarcoplasmic membrane integrity were observed. However, cardiac muscle fibers with mitochondrial edema and lysis occurred in the discharge group. In all experimental groups hepatic glycogen and adrenal lipids were not depleted. Conclusion: Results evidenced that the alarm reaction did not occur immediately after the countershocks although atrium myocardial ultrastructure presented severe injury signals. The present investigation was helpful, since important information should be considered in clinical application field on myocardial protection proceedings before and after application of transthoracic countershock discharges.
    Full-text · Article · Der Kardiologe
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