Elsevier

Resuscitation

Volume 67, Supplement 1, December 2005, Pages S3-S6
Resuscitation

European Resuscitation Council Guidelines for Resuscitation 2005: Section 1. Introduction

https://doi.org/10.1016/j.resuscitation.2005.10.002Get rights and content

Section snippets

Consensus on science

The International Liaison Committee on Resuscitation (ILCOR) was formed in 1993.9 Its mission is to identify and review international science and knowledge relevant to CPR, and to offer consensus on treatment recommendations. The process for the latest resuscitation guideline update began in 2003, when ILCOR representatives established six task forces: basic life support; advanced cardiac life support; acute coronary syndromes; paediatric life support; neonatal life support; and an

From science to guidelines

The resuscitation organisations forming ILCOR will publish individual resuscitation guidelines that are consistent with the science in the consensus document, but will also consider geographic, economic and system differences in practice, and the availability of medical devices and drugs. These 2005 ERC Resuscitation Guidelines are derived from the CoSTR document but represent consensus among members of the ERC Executive Committee. The ERC Executive Committee considers these new recommendations

Demographics

Ischaemic heart disease is the leading cause of death in the world.13, 14, 15, 16, 17 Sudden cardiac arrest is responsible for more than 60% of adult deaths from coronary heart disease.18 Based on data from Scotland and from five cities in other parts of Europe, the annual incidence of resuscitation for out-of-hospital cardiopulmonary arrest of cardiac aetiology is 49.5–66 per 100,000 population.19, 20 The Scottish study includes data on 21,175 out-of-hospital cardiac arrests, and provides

The Chain of Survival

The actions linking the victim of sudden cardiac arrest with survival are called the Chain of Survival. They include early recognition of the emergency and activation of the emergency services, early CPR, early defibrillation and early advanced life support. The infant-and-child Chain of Survival includes prevention of conditions leading to the cardiopulmonary arrest, early CPR, early activation of the emergency services and early advanced life support. In hospital, the importance of early

The universal algorithm

The adult basic, adult advanced and paediatric resuscitation algorithms have been updated to reflect changes in the ERC Guidelines. Every effort has been made to keep these algorithms simple yet applicable to cardiac arrest victims in most circumstances. Rescuers begin CPR if the victim is unconscious or unresponsive, and not breathing normally (ignoring occasional gasps). A single compression–ventilation (CV) ratio of 30:2 is used for the single rescuer of an adult or child (excluding

Quality of CPR

Interruptions to chest compressions must be minimised. On stopping chest compressions, the coronary flow decreases substantially; on resuming chest compressions, several compressions are necessary before the coronary flow recovers to its previous level.27 Recent evidence indicates that unnecessary interruptions to chest compressions occur frequently both in and out of hospital.28, 29, 30, 31 Resuscitation instructors must emphasise the importance of minimising interruptions to chest

Summary

It is intended that these new guidelines will improve the practice of resuscitation and, ultimately, the outcome from cardiac arrest. The universal ratio of 30 compressions to two ventilations should decrease the number of interruptions in compression, reduce the likelihood of hyperventilation, simplify instruction for teaching and improve skill retention. The single-shock strategy should minimise ‘no-flow’ time. Resuscitation course materials are being updated to reflect these new guidelines.

References (31)

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    Sedation level was assessed by nurses every 3 h and awakening was defined by the presence of 3 consecutive RASS scores of at least −2 (patient briefly awakens with eye contact to voice), as previously reported.19 In patients who were still comatose 72 h after sedation discontinuation, a multimodal prognostication protocol was used, according to current guidelines (ESM).3,20–22 Burst suppression or refractory status epilepticus were part of our algorithm.

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