Paediatric update with Patrick Van de Voorde. If they look like an adult, use adult guidelines. BVM is first line. Oxygen is a drug and should titrate to 94-98%. Reassess frequently with fluid boluses #RESUS20
AEDs in paediatrics is difficult due to aetiology but may still make a difference. If you are a two rescuer team please do locate and apply AED in paediatric arrests. Follow your BLS or PLS training for ratios of 15/2 and 30/2. If untrained, call EMS for assistance #RESUS20
Newborn updates with Charles Roehr #RESUS20 very active research area. Keep 2015 guidelines until 2020 officially released! Ideal O2 conc is controversial. Majority <32/40 will require O2 aim between air-30%. Term babies aim room air
Breathing support at birth is not "one size fits all". Subgroup of babies develop dive reflex and stop breathing with PEEP #RESUS20 sustained inflations are not recommended - the smaller the baby the worse they fare
Continue with 5 inflation breaths of 2-3 seconds as per 2015. Tracheal suctioning is now discouraged in routine amniotic stained fluid births! Ventilate first results in fewer babies to NICU with meconium aspiration #RESUS20#neonatal
Neonatal Resuscitation is changing. Leave your comments and thoughts on the ERC.edu public space
First aid updates with David Zideman #RESUS20@ERC_ALS_SEC@ERC_resus recovery position only for those with abnormal breathing. Cooling for heat stroke life saving peri arrest. Tourniquets should only be removed by a HCP once put on!
First aid: Thermal burns need cooling for 20minutes minimum. Compression wrap alone doesn't have an indication but may be helpful when used as part of RICE strategy #RESUS20#firstaid
A problem is the belief that anyone who is unresponsive should be put in recovery position. May not be the case! Can be useful in certain circumstances when breathing normally to stop airway obstructing. But should only be done when having to leave the person alone #firstaid
Ethics update with Spiros Mentzelopoulos #RESUS20 advanced care planning is fundamental for shared decision making and safeguarding. Need pre determined criteria for withholding/terminating CPR @ERC_resus
Education update with Tino Grief #RESUS20 new chapter coming with guidelines 2020! Resuscitation is a blend of learning in your own bespoke way and practical assessment from the experts to stay competent @ERC_resus
• • •
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!