2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Abstract

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation; an observational prospective study

“…Adequate ventilation, improved oxygenation, and avoidance of aspiration are important factors concerning the rate of ROSC as well as the neurological outcome of a patient undergoing CPR [1,2]. Current updated international recommendations for advanced airway management from the International Liaison Committee on Resuscitation (ILCOR) suggest supraglottic devices for adults with Out-of-hospital cardiac arrest (OHCA) in settings with a low intubation success rate [3]. In case of less experienced providers they recommended mask ventilation or supraglottic devices in order to not interrupt chest compressions.…”

Effects of positive dispatcher encouragement on the maintenance of bystander cardiopulmonary resuscitation quality

“…The role of emergency medical dispatchers is not only to quickly recognize cardiac arrest, but also to guide bystanders to start CPR quickly and to achieve a high-quality CPR. [ 5 ] DACPR has successfully increased the likelihood of performing chest compressions on cardiac arrest. [ 6 ] However, the quality of CPR has been found to be very low when compared with that in the recommended guidelines.…”

Education, Implementation, and Teams

“…14,15 A SysRev on this topic has been published 133 and was included in the 2019 CoSTR summary. 5,6 Population, Intervention, Comparator, Outcome, Study Design, and Time Frame Population: Adults with attempted resuscitation after nontraumatic IHCA or OHCA Intervention: Treatment at a specialized cardiac arrest center Comparator: Treatment in a healthcare facility not designated as a specialized cardiac arrest center Outcome: 30-day survival with favorable neurological outcome (defined as Cerebral Performance Category 1 or 2, modified Rankin Scale score 0À3), survival at hospital discharge with favorable neurological outcome, survival at 30 days, and survival at hospital discharge and ROSC after hospital admission Study designs: RCTs and nonrandomized studies (non-RCTs, interrupted time series, controlled before-and-after studies, cohort studies) were eligible for inclusion. Unpublished studies (eg, conference abstracts, trial protocols) were excluded, as well as studies reporting pediatric cardiac arrests (18 years old or younger) and cardiac arrest secondary to trauma.…”

“…For regional triage of OHCA patients to a cardiac arrest center by primary EMS transport or secondary interfacility transfer subgroups, the current evidence is inconclusive and confidence in the effect estimates is currently too low to support a separate EIT and ALS Task Force recommendation. 5,6 Out-of-Hospital CPR Training in Low-Resource Settings (EIT 634: ScopRev)…”