ILCOR Summary Statement2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations☆,☆☆
Section snippets
Dispatcher instruction in CPR: DA-CPR—adults
The emergency medical dispatcher is an essential link in the chain of survival.13, 14 In addition to dispatching emergency medical services (EMS) resources to medical emergencies, emergency medical dispatchers are increasingly being trained to recognize cardiac arrest, to assist bystanders in initiating resuscitation, and to support bystanders in optimizing resuscitation efforts. The international community is continuing to explore ways to increase bystander CPR for cardiac arrests. One such
Advanced airway interventions during adult cardiac arrest
It is important to identify those airway interventions most likely to improve outcomes for both OHCA and IHCA. Chest compressions alone do not provide adequate ventilation during prolonged cardiac arrest. Airway management is therefore required to facilitate ventilation and to reduce the risk of gastric regurgitation and aspiration. The best airway strategy for improving patient outcomes is uncertain. On the basis of the evidence available at the time, the 2015 CoSTR suggested using either an
Pediatric life support
The Pediatric Life Support Task Force reviewed 4 topics for this 2019 CoSTR: DA-CPR, advanced airway interventions in pediatric cardiac arrest, ECMO CPR (ECPR), and TTM during post–cardiac arrest care. An SR was published for each of these topics.3, 6, 7, 8 The Pediatric Life Support Task Force then reviewed the SR and the studies identified by the SR and generated a CoSTR that was posted on the ILCOR website for public comments for each topic. This document contains a summary of the 4 CoSTRs,
Initial oxygen concentration for term infants at birth
Administration of high oxygen concentrations leads to free radical formation and may be toxic to lungs, eyes, brains, and other organs of the newborn.151, 152 In 2010, the ILCOR NLS Task Force CoSTR update noted that it was best to start with 21% oxygen when term newborns received positive-pressure ventilation in the delivery room. The recommendation was based on a meta-analysis that found lower mortality when room air instead of 100% oxygen was used.153 The evidence review for this question
CACs versus non-CACs
CACs are hospitals providing evidence-based resuscitation treatments, including emergency interventional cardiology, bundled critical care with TTM, and protocolized cardiorespiratory support and prognostication.48, 63
This population, intervention, comparator, outcome, study design, and time frame was prioritized for review by the EIT and ALS Task Forces on the basis of the publication of several large registry studies188, 189 since the 2015 ILCOR ALS48, 63 and EIT CoSTRs.190, 191 In the
Presyncope
Presyncope, or near-syncope, is the prodrome of syncope and is characterized by light-headedness, nausea, diaphoresis, and a feeling of impending loss of consciousness. A progression to syncope results in global cerebral hypoperfusion and transient loss of consciousness; loss of postural tone can result in physical injury in up to 30% of patients.214 This review evaluated nonpharmacological first aid interventions that can be applied at the onset or immediately after the onset of presyncope
Disclosures
Writing group disclosuresWriting group member Employment Research grant Other research support Speakers’ Bureau/Honoraria Expert witness Ownership interest Consultant/advisory board Other Jasmeet Soar Southmead Hospital North Bristol NHS Trust (United Kingdom) None None None None None None None Richard Aickin Starship Children’s Hospital (New Zealand) None None None None None None None Lars W. Andersen Aarhus University (Denmark) Amomed Pharma GmbH (PI on a clinical trial involving vasopressin and methylprednisolone. The
References (223)
- et al.
GRADE guidelines, 1: introduction: GRADE evidence profiles and summary of findings tables
J Clin Epidemiol
(2011) - et al.
A systematic review and meta-analysis of the effect of dispatcher-assisted CPR on outcomes from sudden cardiac arrest in adults and children
Resuscitation
(2019) - et al.
Advanced airway management during adult cardiac arrest: a systematic review
Resuscitation
(2019) - et al.
Vasopressors during adult cardiac arrest: a systematic review and meta-analysis
Resuscitation
(2019) - et al.
Extracorporeal cardiopulmonary resuscitation for cardiac arrest: a systematic review
Resuscitation
(2018) - et al.
Advanced airway interventions for paediatric cardiac arrest: a systematic review and meta-analysis
Resuscitation
(2019) - et al.
Paediatric targeted temperature management post cardiac arrest: a systematic review and meta-analysis
Resuscitation
(2019) - et al.
Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? A systematic review
Resuscitation
(2019) - et al.
Part 3: adult basic life support and automated external defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations
Resuscitation
(2015) - et al.
Dispatcher-assisted telephone CPR: common delays and time standards for delivery
Ann Emerg Med
(1991)
Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: a before-after population-based study
Resuscitation
Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) emergency medical services centres
Resuscitation
A before-after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore
Resuscitation
Emergency call processing and survival from out-of-hospital ventricular fibrillation
Resuscitation
Effects of dispatcher-assisted cardiopulmonary resuscitation on survival outcomes in infants, children, and adolescents with out-of-hospital cardiac arrests
Resuscitation
Does dispatcher-assisted CPR generate the same outcomes as spontaneously delivered bystander CPR in Japan?
Am J Emerg Med
Telephone cardiopulmonary resuscitation is independently associated with improved survival and improved functional outcome after out-of-hospital cardiac arrest
Resuscitation
Effects of dispatcher-assisted bystander cardiopulmonary resuscitation on neurological recovery in paediatric patients with out-of-hospital cardiac arrest based on the pre-hospital emergency medical service response time interval
Resuscitation
Recognising out-of-hospital cardiac arrest during emergency calls increases bystander cardiopulmonary resuscitation and survival
Resuscitation
Association of dispatcher-assisted bystander cardiopulmonary resuscitation with survival outcomes after pediatric out-of-hospital cardiac arrest by community property value
Resuscitation
Recruitments of trained citizen volunteering for conventional cardiopulmonary resuscitation are necessary to improve the outcome after out-of-hospital cardiac arrests in remote time-distance area: a nationwide population-based study
Resuscitation
Time to identify cardiac arrest and provide dispatch-assisted cardio-pulmonary resuscitation in a criteria-based dispatch system
Resuscitation
Use of telephone CPR advice in Ireland: uptake by callers and delays in the assessment process
Resuscitation
Dispatcher-assisted bystander cardiopulmonary resuscitation in rural and urban areas and survival outcomes after out-of-hospital cardiac arrest
Resuscitation
Part 4: advanced life support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations
Resuscitation
Airway management and out-of-hospital cardiac arrest outcome in the CARES registry
Resuscitation
Esophageal gastric tube airway vs endotracheal tube in prehospital cardiopulmonary arrest
Chest
Comparison of a conventional tracheal airway with the Combitube in an urban emergency medical services system run by physicians
Resuscitation
Impact of laryngeal tube use on chest compression fraction during out-of-hospital cardiac arrest: a prospective alternate month study
Resuscitation
Should laryngeal tubes or masks be used for out-of-hospital cardiac arrest patients?
Am J Emerg Med
Randomised comparison of the effectiveness of the laryngeal mask airway supreme, i-gel and current practice in the initial airway management of out of hospital cardiac arrest: a feasibility study
Br J Anaesth
Epinephrine in cardiac resuscitation
Am Heart J
Effect of adrenaline on survival in out-of-hospital cardiac arrest: a randomised double-blind placebo-controlled trial
Resuscitation
The effects of adrenaline in out of hospital cardiac arrest with shockable and non-shockable rhythms: findings from the PACA and PARAMEDIC-2 randomised controlled trials
Resuscitation
Randomised comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation
Lancet
Reduced effectiveness of vasopressin in repeated doses for patients undergoing prolonged cardiopulmonary resuscitation
Resuscitation
Usefulness of vasopressin administered with epinephrine during out-of-hospital cardiac arrest
Am J Cardiol
Effect of the addition of vasopressin or vasopressin plus nitroglycerin to epinephrine on arterial blood pressure during cardiopulmonary resuscitation in humans
J Emerg Med
Vasopressin versus epinephrine for inhospital cardiac arrest: a randomised controlled trial
Lancet
Out-of-hospital use of an automated chest compression device: facilitating access to extracorporeal life support or non-heart-beating organ procurement
Am J Emerg Med
Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis
Lancet
Comparing the survival between extracorporeal rescue and conventional resuscitation in adult in-hospital cardiac arrests: propensity analysis of three-year data
Resuscitation
The incidence of “load&go” out-of-hospital cardiac arrest candidates for emergency department utilization of emergency extracorporeal life support: a one-year review
Resuscitation
Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: a prospective observational study
Resuscitation
Two-year survival and neurological outcome of in-hospital cardiac arrest patients rescued by extracorporeal cardiopulmonary resuscitation
Int J Cardiol
Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation
Resuscitation
Utstein style study of cardiopulmonary bypass after cardiac arrest
Am J Emerg Med
Mechanical chest compressions improve rate of return of spontaneous circulation and allow for initiation of percutaneous circulatory support during cardiac arrest in the cardiac catheterization laboratory
Resuscitation
Room air for initiating term newborn resuscitation: a systematic review with meta-analysis
Pediatrics
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This article has been copublished in Circulation.
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Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.