Best practice & research. Clinical anaesthesiology
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Best Pract Res Clin Anaesthesiol · Sep 2013
Schoolchildren as lifesavers in Europe - training in cardiopulmonary resuscitation for children.
Sudden cardiac arrest is a major contributor to avoidable deaths in Europe. Immediate initiation of basic life support (BLS) by lay bystanders is among the most successful strategies in its treatment. Despite the fact that more than half of all cardiac arrests are witnessed in a number of European countries, layperson resuscitation is initiated in only one-fifth of all cases. ⋯ BLS instructions for schoolchildren - including the use of automatic external defibrillators (AEDs) - have been shown to be feasible independently of the children's age or physical ability. Nonetheless, it appears reasonable to implement age-adjusted curricula. The earlier in the course of life-long learning BLS instruction begins, the more sustainable training may be.
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Best Pract Res Clin Anaesthesiol · Sep 2013
ERC initiatives to reduce the burden of cardiac arrest: the European Cardiac Arrest Awareness Day.
The rate of survival from out-of-hospital cardiac arrest in Europe remains unacceptably low and could be increased by better bystander cardiopulmonary resuscitation (CPR) rates. The European Resuscitation Council has announced that there will be a European Cardiac Arrest Awareness Day every year on the 16th of October. ⋯ The topic of this year's Awareness Day is 'Children Saving Lives' and it is hoped that all national resuscitation councils will promote awareness of the benefits of training all children in CPR and AED use and lobby for legislative change to ensure that all children receive this training. Children are not just the adults of tomorrow - they are the lifesavers of today and tomorrow.
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Basic Life Support has changed significantly over the last 15 years. Evidence-based changes in recommendations involved compression rate, compression depth and the ratio between compressions and ventilations. There is much evidence that early basic life support increases the probability of survival two- to three-fold. ⋯ For those who have been trained in BLS and who are willing to give full CPR, should administer ventilations and chest compressions according to the guidelines. The AED plays a key role in early management of cardiac arrest and can substantially contribute to better survival. Logistics of placement of AEDs and the optimal way to bring AEDs to a victim require much more efforts, especially for victims in residential area's, where the great majority of cases of cardiac arrest occur.
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More than 10 years ago, the randomised studies of therapeutic hypothermia after cardiac arrest showed significant improvement of neurological outcome and survival. Since then, it has become clear that most of the possible adverse events of therapeutic hypothermia are mild and can easily be controlled by proper administration of intensive care. ⋯ Hence, the exact level of target temperature, duration of cooling, rewarming, timing of the therapy and concomitant medication to facilitate therapeutic hypothermia will be important in the future. Additionally, the use of a post-resuscitation treatment bundle (specialised cardiac-arrest centres including intensive post-resuscitation care, appropriate haemodynamic and respiratory management, therapeutic hypothermia and percutaneous coronary intervention) could further improve treatment of cardiac arrest.
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Best Pract Res Clin Anaesthesiol · Sep 2013
Cardiac aetiology of cardiac arrest: percutaneous coronary interventions during and after cardiopulmonary resuscitation.
Management and prevention of cardiac arrest in the setting of heart disease is a challenge for modern cardiology. After reviewing the aetiology of sudden cardiac death and discussing the way to identify candidates at risk, we emphasise the role of percutaneous coronary interventions during and after cardiopulmonary resuscitation in the treatment of patients with return of spontaneous circulation after cardiac arrest.