Check out ERC.edu and click on guidelines for public comment to see the latest changes and key recommendations #RESUS20
Systems save lives highlighting systemic changes we can make globally by engaging governments and linking up the chain of survival @fsemeraro1973#RESUS20#kidssavelives
BLS updates with @olasveengen agonal breathing and seizures confuse the picture. These are not signs of life! #RESUS20#CPR
Rescuers safety always comes first. PPE before CPR! we don’t want Covid fears to take us backwards in our advances #RESUS20#AED#CPR AED's are safe to use even for lay rescuers @olasveengen
Controversial topics: adrenaline increases survival to hospital admission and discharge @TDjarv#RESUS20 Airways: whatever gets air in, use it. IV access before IO as it seems more effective. Ultrasound is good for identifying tamponade but not much else #controversial
Don’t take away from the things we know work and are easy: compressions, drugs etc just to spend time playing with ultrasound. The chain is still important #RESUS20
Post resus care with Prof Jerry Nolan #RESUS20 targets and considerations! Go read the new draft guidelines ERC.edu
Post resus care starts from the moment the patient gets ROSC. This could be pre hospital and not just the domain of our wonderful ICU colleagues #RESUS20
Revised prognostication algorithm #RESUS20#postresuscare need AT LEAST 2 of these for a favourable outcome. Neuroprognostication is tricky, suggest at least 72hours but often in practice takes longer than this @ERC_ALS_SEC@ERC_resus
TTM recommendation is unchanged from 2015 guidelines. Some form of constant temp control for 32-36*c for first 72 hours. May require modifications after TTM2 #RESUS20
Resus in special circumstances with Carsten Lott: remember your 4H’s & 4T’s! #RESUS20@ERC_ALS_SEC
• • •
Missing some Tweet in this thread? You can try to
force a refresh
First up @abbamamma discussing the size of the problem with dispatchers/HCPs not being exposed to high loads of cardiac arrest calls and seizure activity a confusing factor #RESUS20
Seizures are hard for lay responders and HCPs to recognise. You can check a pulse as an indication of cardiac arrest but this is hard to teach lay rescuers. Plus arrhythmia may cause a seizure. How do we tackle this?? #RESUS20#CPR
Can AI help our dispatchers when trying to multi task: taking the call, talking to lay rescuer, dispatching EMS #RESUS20 is protocol with specific training or level of medical training a better system?
From the NCAA data we know there are around 250 paediatric cardiac arrests in UK hospitals each year! A study over a 7 year period found the majority of arrests had non shockable rhythms (95.7%)
Despite these being associated with worse outcomes in adults, a survival to hospital discharge of 54.2% was seen.
ReSPECT has been a big development in UK resuscitation as it aims to create a greater conversation around advanced care planning!
The UK national cardiac arrest audit has input from 176 uk hospitals. This year has seen a slight decrease in incident of IHCA and in survival, but this year has been affected by COVID and may therefore not be comparable!
There has been a steady increase in bystander CPR - there has also been an increase in bystander AED use but this value still sits below 10%
@NHSuk have developed a new telephone triage system to help with early recognition of OHCA to help strengthen that first link in the classic chain of survival!
In our next talk, Kirstie Haywood from @warwickmed is speaking about cardiac arrest outcomes!
We know that life after survival from cardiac arrest has difficulties, with up to 55% of survivors having cognitive impairment at 6 months post cardiac arrest!
The majority of recovery is likely to occur in the first 3 months with minor improvement up to 12 months - after this, dysfunction is likely to be persistent!
Routine screening of cognitive function prior to discharge is recommended, followed by reassessment throughout the first three months!
Resus councils faced a difficult time this year as many training sessions were cancelled and staff diverted to clinical roles
We have long known that technology is the future - but now it’s clear that technology is now. This is relevant for both education of clinical staff but also for public engagement!