Nihon rinsho. Japanese journal of clinical medicine
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[Immediate Cardiac Life Support (ICLS) course developed by Japanese Association for Acute Medicine].
The Immediate Cardiac Life Support (ICLS) course was developed and launched by Japanese Association for Acute Medicine (JAAM) for resident training, in April 2002. The ICLS course is designed as multi-professional one-day (8 hours) resuscitation course and teaches the essential skills and team dynamics required to manage a patient in cardiac arrest for 10 minutes before the arrival of a cardiovascular specialist. The course consists of skill stations and scenario stations. ⋯ In total, 117,246 candidates attended 6,971 ICLS courses until the end of December 2010. Furthermore, we developed additional course of ICLS to manage stroke, Immediate Stroke Life Support (ISLS). We also describe the development and structure of, and rationale for the ICLS course.
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The percutaneous cardiopulmonary support (PCPS) allows maintaining the patient's cardiac and pulmonary status with low cardiac or pulmonary performance due to acute myocardial infarction, pulmonary thromboembolism, postoperative phase of great blood vessels/open heart surgery or percutaneous coronary intervention, and so on. This system consists of a centrifugal pump with its control system, membrane oxygenator, measure devices for blood flow and pressure and a heating system for temperature conditioning of blood. ⋯ However, multicenter study about the utility of ECPR used PCPS for the out-of-hospital cardiac arrest(Study of Advanced life support for Ventricular fibrillation with Extracorporeal circulation in Japan: SAVE-J) is started in April 2007, and it is said that ECPR may improve neurological outcome comparing with that of the conventional CPR by the interim report. Further studies will determine its efficacy and adequate criteria.
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Key changes in Guideline 2010 by Japanese Resuscitation Council were described and the reasons of the change were explained based on 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with Treatment Recommendations. In BLS, the value of chest compression was further emphasized and it became an initial skill of CPR In ALS, post resuscitation care was systemized by incorporating hypothermia, PCI, and other diagnostic and therapeutic modalities. ⋯ Use of AED was expanded to infant. Education, Implementation and Teams were newly included as a chapter to promote the knowledge and skill of resuscitation science into the society.
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New guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) were released in October 2010. The 2010 Guidelines changed a core concept of basic life support from traditional A-B-C (Airway, Breathing, Chest compressions) procedure to C-A-B (Chest compressions, Airway, Breathing) procedure. ⋯ Japanese researchers contributed to the revision of the guidelines from a stage of establishment of a CoSTR(2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations) which gives the guidelines theoretical evidences. It is expected for us to promote resuscitation science even in traditional theoretical field but also in the field of education, implementation, and team approach.
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The American Heart Association (AHA) and other member councils of International Liaison Committee on Resuscitation (ILCOR) complete review of resuscitation science every 5 years. And ILCOR publishes Consensus on Science with Treatment Recommendations(CoSTR). The AHA published "American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation(CPR) and Emergency Cardiovascular Care (ECC)" (G2010), that basis on CoSTR 2010 on Oct. 18th, 2010. ⋯ The AHA maintains the quality of their training courses by some systems. AHA instructors are trained by some steps of instructor courses and monitoring systems and update their scientific knowledge on resuscitation by e-learning. The authors introduce an outline of basic life support for healthcare providers, the instructor training systems of AHA and summary of basic life support basis on G2010.