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!
PTSD is seen in around 1 in 4 cardiac arrest survivors, but levels are even higher in caregivers, who may have guilt based around the survivors ongoing issues.
Physical function impairment is also common. This can be based around muscle wasting or around fatigue and pain.
It is well known that rib fractures are common in cardiac arrest (around 60% of patients) but we talk very little about the pain that cardiac arrest survivors are likely to have! This may be a key point for future post resuscitation care to improve long term patient outcomes
It is therefore clear that survivors may have a wide variety of unrecognised and unmet needs - with long term follow up required! High quality studies may therefore be required to ensure there is sufficient evidence with buy in from stakeholders to make these changes reality!
Thanks for a fantastic talk Kirstie - it is fascinating to hear someone talking about the long term impact of cardiac arrest, something which doesn’t get as much attention as it deserves! #RESUS20@ERC_resus@ERC_ALS_SEC@ResusCouncilUK
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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!
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!
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