These European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment ...Recommendations. This section provides guidelines on the modifications required to basic and advanced life support for the prevention and treatment of cardiac arrest in special circumstances; specifically special causes (hypoxia, trauma, anaphylaxis, sepsis, hypo/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tension pneumothorax, toxic agents), special settings (operating room, cardiac surgery, catheter laboratory, dialysis unit, dental clinics, transportation (in-flight, cruise ships), sport, drowning, mass casualty incidents), and special patient groups (asthma and COPD, neurological disease, obesity, pregnancy).
Abstract Aim In out of hospital cardiac arrest (OHCA) a single rescuer should start with cardiopulmonary resuscitation (CPR) immediately after calling the Emergency Medical Communication Centre ...(EMCC). The start of CPR may be delayed considerably if the total time to connect to the dispatcher at the EMCC (TT-EMCC) is prolonged. EUROCALL aimed to investigate the TT-EMCC and its components in several European regions using different calling procedures. Methods EUROCALL is a prospective, multicentre randomised study that was performed in April 2013. Conducted from a landline or a mobile phone, calls were randomly allocated to day and time of the call, and to those connecting directly to the EMCC (1-step procedure) and those that needed to be diverted before connecting to the EMCC (2-step procedure). Results Twenty-one EMCC’s from 11 countries participated in the study. For the 1878 1-step calls, median times were: time from dial to first ringtone 3.7 seconds (IQR 1.0-5.2) and time from first ringtone to response by call-taker 6.4 seconds (IQR 2.9 − 13.5). The median TT- EMCC was 11.7 seconds (IQR 8.7-18.5). For the 1550 2-step calls, median times were: time to first ringtone 4.0 seconds (IQR 2.4 − 5.2), from first ringtone to first call-taker 7 seconds (IQR 4.6 − 11.9) and from first call-taker to EMCC 18.7 seconds (IQR 13.4-29.9). Median TT-EMCC was 33.2 seconds (IQR 24.7-46.1) and was significantly longer than the TT-EMCC that was observed with the 1-step procedure (P < 0.0001). Significant differences existed among participating regions between and within different countries both for 1-step and 2-step procedures. No significant differences existed in TT-EMCC between landlines and mobile lines. Conclusion TT-EMCC was significantly shorter in a 1-step procedure compared to a 2-step procedure. We found regional differences between countries but also within countries. This may be relevant in cases of OHCA and other situations where patient outcome is critically time-dependent.
Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high ...quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR).
In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed.
A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17–1.83).
In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.
Zusammenfassung
Die Leitlinien des European Resuscitation Council 2021 basieren auf einer Reihe systematischer Übersichtsarbeiten, Scoping-Reviews und Aktualisierungen der Evidenz des International ...Liaison Committee on Resuscitation und stellen die aktuellsten evidenzbasierten Leitlinien für die Praxis der Wiederbelebung in ganz Europa dar. Die Leitlinien umfassen die Epidemiologie des Kreislaufstillstands, die Rolle, die Systeme bei der Rettung von Menschenleben spielen, die Basismaßnahmen der Wiederbelebung Erwachsener, die erweiterten Reanimationsmaßnahmen bei Erwachsenen, die Wiederbelebung unter besonderen Umständen, die Postreanimationsbehandlung, die Erste Hilfe, die Versorgung und Reanimation von Neugeborenen, die lebensrettenden Maßnahmen bei Kindern, die Ethik und die Ausbildung.
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