Abstract

New European Resuscitation Council Guidelines are discussed in the paper. European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required to basic and advanced life support for the prevention and treatment of cardiac arrest in special circumstances; specifically special causes (hypoxia, trauma, anaphylaxis, sepsis, hypo/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tensionpneumothorax, toxic agents), special settings (operating room, cardiac surgery, catheter laboratory, dialysis unit, dental clinics, transportation (in-flight, cruise ships), sport, drowning, mass casualty incidents), and special patient groups (asthma and COPD, neurological disease, obesity, pregnancy). There are no major changes in the 2021 adult Special Circumstances guidelines. There is greater emphasis on the priorisation of recognition and management for reversible causes in cardiac arrest due to special circumstances. The guidelines reflect the increasing evidence for extracorporeal CPR (eCPR) as management strategy for selected patients with cardiac arrest in settings in which it can be implemented. Diagnostic criteria and therapeutic approaches are discussed.

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