International Liaison Committee On Resuscitation Research Articles

European Resuscitation Council Guidelines 2000 for Basic Paediatric Life Support: A statement from the Paediatric Life Support Working Group and approved by the Executive Committee of the European Resuscitation Council

The European Resuscitation Council (ERC) last issued guidelines for Paediatric Life Support (PLS) in 1998 [1]. These were based on the "Advisory Statements" of the International Liaison Committee on Resuscitation (ILCOR) published in 1997 [2]. Following this, the American Heart Association, together with representatives from ILCOR, undertook a series of evidence-based evaluations of the science of resuscitation which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [3,4]. The Paediatric Life Support Working Party of the European Resuscitation Council has considered this document and the supporting scientific literature and has recommended changes to the ERC Basic PLS guidelines. These are presented in this paper. There have been few major changes to the ERC recommended guidelines as some of the changes agreed in "Guidelines 2000" had already been introduced into Europe subsequent to the 1998 ILCOR "Advisory Statements" (Fig. 1).

European Resuscitation Council Guidelines 2000 for Automated External Defibrillation: A statement from the Basic Life Support and Automated External Defibrillation Working Group and approved by the Executive Committee of the European Resuscitation Council

The European Resuscitation Council (ERC) last issued guidelines for Automated External Defibrillators (AEDs) in 1998 [1]. The American Heart Association, together with representatives from the International Liaison Committee on Resuscitation (ILCOR), then undertook a series of evidence-based evaluations of the science of resuscitation [2] which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [3,4]. The Basic Life Support and Automated External Defibrillation Working Group (BLS&AED Working Group of the ERC) has considered this document and has recommended changes in the ERC AED guidelines. These are presented in this paper.

European Resuscitation Council Guidelines 2000 for Adult Advanced Life Support: A statement from the Advanced Life Support Working Group and approved by the Executive Committee of the European Resuscitation Council

The European Resuscitation Council (ERC) last issued guidelines for Basic Life Support (BLS) in 1998 [1]. These were based on the 1997 International Liaison Committee on Resuscitation (ILCOR) Advisory Statements [2]. In 1999 and 2000 representatives of ILCOR, at the invitation of the American Heart Association, met on a number of occasions in Dallas to agree a Consensus on Science upon which future guidelines would be based. Representatives from the ERC played a prominent role in the deliberations, which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care--A Consensus on Science" in August 2000 [3]. The consensus was evidence-based wherever possible. The ERC ALS Working Group has considered this document and has recommended some changes in the guidelines that will be suitable for European practice. These changes, together with a summary of the Sequence of Actions in ALS, are presented in this paper.

Part 11: Neonatal Resuscitation

Part 11: Neonatal Resuscitation

Part 12: From Science to Survival

Part 12: From Science to Survival

The new German resuscitation guidelines in the context of international recommendations

The German Guidelines for Cardiopulmonary Resuscitation were adapted to match the revised International Guidelines. The revised German edition was based both on the guidelines issued by the American Heart Association (AHA) in 1992 and on those of the European Resuscitation Council (ERC) of 1998, as well as on those released by the International Liaison Committee on Resuscitation (ILCOR) in 1997. Due to the diverging instructions for action the emergency physicians felt considerably unsafe as to what they should really do to achieve maximum results. Only 10.3 per cent of the german emergency physicians followed the recommendations given by the German Federal Chamber of Physicians. Innovations in respect of the basic checkup concern the time for controlling the respiration and circulation (ten seconds). Contrary to the international recommendations the "diagnostic block" is performed in Germany without interspersing basic reanimation. In artificial respiration the tidal volume has been reduced to 600 ml in accordance to the ERC and ILCOR guidelines. The search for the pressure point for cardiac pressure massage has also been adapted to the international recommendations. Also in accordance with the international recommendations defibrillation in case of ventricular fibrillation is now being performed only thrice in series without interspersed basic reanimation. There is some uncertainty with regard to choosing the requisite energy: 16.6% of the emergency physicians opt for less than 200 joule in primary defibrillation whereas 13% are in favour of more than 200 joule. Contrary to the international recommendations which prescribe peripheral venous access as application site for reanimation by drugs, the german guidelines favour the endobronchial path, which is already being practised by 57.4% of the emergency physicians. Hence, emergency medication can be effected in Germany 4 minutes earlier than in other countries. After three unsuccessful applications of 1 mg each of adrenalin the dosage is increased to 5 mg, and in agreement with the AHA guidelines escalating doses are also possible. Sodium bicarbonate is recommended only after more than 20 minutes of reanimation and if so, only in a reduced dose of 0.5 mval/kg body weight. In accordance with the international recommendations there is now a universal algorithm that decides on application only between ventricular fibrillation and nonfibrillation. The new german recommendations have adapted the reanimation procedure in agreement with ERC to national usage without abandoning any principles of the international guidelines.

A comparison of manikin CPR performance by lay persons trained in three variations of basic life support guidelines

This paper reports on a randomised controlled trial comparing the acquisition and retention of cardiopulmonary resuscitation (CPR) skills by lay persons trained in three variations of basic life support. Training was provided either in 1992 European Resuscitation Council (ERC) guidelines, or in the 1997 International Liaison Committee on Resuscitation (ILCOR) Advisory Statement (adopted with minor revisions as 1998 ERC guidelines), and an American Heart Association ‘call first’ version of the 1997 ILCOR statement. Evaluation of manikin CPR using the established Cardiff tests (CARE and VIDRAP) showed that 51% of those trained in the current ILCOR guidelines performed effectively compared with 38% trained in the ERC 1992 guidelines and 25% trained in the ‘call first’ variation ( P<0.01). Whilst the current ERC and ILCOR guidelines appeared easiest to learn, retention at 6 months was poor (14% effective) irrespective of method.

Consensus and controversy over resuscitation of the ne wborn infant

Resuscitation organisations represented on the International Liaison Committee on Resuscitation (ILCOR), together with two paediatric resuscitation organisations and WHO, have produced a consensus statement on advanced life support for newborn babies. 1 Kattwinkel J Niermeyer S Nadkarni V et al. Resuscitation of the newly born infant: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Circulation. 1999; 99: 1927-1938 Crossref PubMed Scopus (79) Google Scholar Basic life support for these children had been addressed in a previous statement. 2 Nadkarni V Hazinski MF Sideman D et al. Pediatric resuscitation: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Circulation. 1997; 95: 2185-2195 Crossref PubMed Scopus (57) Google Scholar The issues addressed in the new statement will have a broad impact. WHO estimates that every year there are one million neonatal deaths attributable to birth asphyxia. 3 World Health Report 1995. WHO, Geneva1997: 21 Google Scholar The impact of birth asphyxia is smaller in more developed countries; in the USA, only 3378 deaths out of almost 4 million births can be ascribed to birth asphyxia (456 deaths) or other complications related to delivery (2922 deaths). 4 Guyer B MacDorman MF Martin JA Peters KD Strobino DM Annual summary of vital statistics-1997. Pediatrics. 1998; 102: 1333-1349 Crossref PubMed Scopus (135) Google Scholar

Resuscitation of the newly born infant: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation.

The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours following birth and the techniques for providing advanced life support.

Resuscitation of the newly born infant: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation

The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours following birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles. (i) Personnel trained in the basic skills of resuscitation should be in attendance at every delivery. A minority (fewer than 10%) of newly born infants require active resuscitative interventions to establish a vigorous cry and regular respirations, maintain a heart rate greater than 100 beats per minute (bpm), and maintain good color and tone. (ii) When meconium is present in the amniotic fluid, it should be suctioned from the hypopharynx on delivery of the head. If the meconium-stained newly born infant has absent or depressed respirations, heart rate, or muscle tone, residual meconium should be suctioned from the trachea. (ii) Attention to ventilation should be of primary concern. Assisted ventilation with attention to oxygen delivery, inspiratory time, and effectiveness judged by chest rise should be provided if stimulation does not achieve prompt onset of spontaneous respirations and/or the heart rate is less than 100 bpm. (iv) Chest compressions should be provided if the heart rate is absent or remains less than 60 bpm despite adequate assisted ventilation for 30 s. Chest compressions should be coordinated with ventilations at a ratio of 3:1 and a rate of 120 ‘events’ per minute to achieve approximately 90 compressions and 30 rescue breaths per minute. (v) Epinephrine should be administered intravenously or intratracheally if the heart rate remains less than 60 bpm despite 30 s of effective assisted ventilation and chest compression circulation. Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.

Successful automatic external defibrillator operation by people trained only in basic life support in a simulated cardiac arrest situation

Objective: To show whether in an in-hospital cardiac arrest, early defibrillation can also be performed by hospital staff trained only in basic life support. Background: The International Liaison Committee on Resuscitation (ILCOR) endorses the concept that in many settings non-medical individuals should be allowed and encouraged to use defibrillators. Methods: Five different groups of hospital staff were evaluated whether they were able to correctly operate an automatic external defibrillator in a simulated sudden cardiac arrest situation without any prior instruction. The participants were assigned either to the ‘basic life support-trained’ group (BLS, n=40) or to the ‘advanced life support-trained’ group (ALS, n=40). Results: All persons of the ‘only BLS-trained’ group delivered the three sequential (‘stacked’) shocks with the automatic external defibrillator when persistent ventricular fibrillation was simulated. The ‘ALS-trained’ persons successfully delivered the three shocks with the automatic external defibrillator in 98% of the cases. When this group used a conventional defibrillator, only 88% were able to deliver the three shocks, however they were able to do it significantly more quickly. Conclusion: Using an automatic defibrillator without any prior instruction, even persons trained only in BLS were able to deliver three sequential shocks in a simulated persistent ventricular fibrillation cardiac arrest.

Recommendations on resuscitation of babies at birth

The International Liaison Committee on Resuscitation (ILCOR), in its 1997 advisory statement on paediatric life support [ 1 International Liaison Committee on Resuscitation (ILCOR)-Advisory statement on Paediatric Life Support. Resuscitation 1997;34:115–128. Google Scholar ], recognised the need to develop consistent international guidelines to be promulgated by national resuscitation councils and associations. These guidelines, known as advisory statements, are based on specific data (outcome validity), but in the absence of specific data, were developed and supported on the basis of common sense (face validity) or ease of teaching or skill retention (construct validity). The ILCOR advisory statement [ 1 International Liaison Committee on Resuscitation (ILCOR)-Advisory statement on Paediatric Life Support. Resuscitation 1997;34:115–128. Google Scholar ]makes specific recommendations for basic resuscitation of the new born. These guidelines have developed and enhanced these concepts and extended them into advanced life support. They are an extension of the guidelines already published by the ERC [ 2 European Resuscitation Council. Guidelines for basic life support. Resuscitation 1992;24:103–110. Br Med J 1993;306:1587–1589. Google Scholar , 3 European Resuscitation Council. Guidelines for advanced life support. Resuscitation 1992;24:111–121. Br Med J 1993;306:1589–1593. Google Scholar , 4 European Resuscitation Council. Guidelines for paediatric life support Resuscitation 1994;27:91–106. Br Med J 1994;308:1349–1355. Google Scholar ]and take into account recommendations made by other national [ 5 Royal College of Paediatrics and Child Health. Resuscitation of babies at birth. BMJ Publishing Group, 1997. Google Scholar , 6 British Paediatric Association. Neonatal resuscitation-the report of a BPA working party. British Paediatric Association 1993, London. Google Scholar ]and international [ 7 American Heart Association. Neonatal advanced life support. JAMA 1996;255:2969–2973. Google Scholar ]organisations.

The 1998 European Resuscitation Council guidelines for adult advanced life support: A statement from the Working Group on Advanced Life Support, and approved by the executive committee of the European Resuscitation Council

The publication of guidelines for advanced life support (ALS) by the European Resuscitation Council (ERC) in 1992 was a landmark in international co-operation and co-ordination [ 1 Guidelines for advanced life support. A statement by the advanced life support working party of the European Resuscitation Council, 1992. Resuscitation 1992;24:111–21. Google Scholar ]. Previously, individual countries or groups had produced guidelines [ 2 Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). J Am Med Assoc 1986;255:2905–89. Google Scholar ]but for the first time an international group of experts produced consensus views based on the best available information. Since 1992, even wider international collaboration and support has occurred. In particular, the establishment of the International Liaison Committee on Resuscitation (ILCOR) has facilitated global co-operation and discussion between representatives from North America, Europe, Southern Africa, Australia, and most recently Latin America. The Advisory Statement produced in 1997 by ILCOR forms the basis for these guidelines [ 3 The ALS working group of the International advisory Committee on Resuscitation. The Universal Algorithm. Resuscitation 1997;34:109–11. Google Scholar ].

Adult resuscitation guidelines

In April of this year at the international meeting in Brighton, the Resuscitation Council of the United Kingdom presented changes to its guidelines for resuscitation. The original guidelines, published in 1992 by the European Resuscitation Council ( ERC ), were the result of a consensus view from international groups of experts based on the most up to date information. The International Liaison Committee on Resuscitation (ILCOR) comprises the ERC, the American Heart Association (AHA), the Australian Resuscitation Council (ARC), the Resuscitation Council of Southern Africa (RCSA), the Heart and Stroke Foundation of Canada (HSFC). and the Cosejo Latinoamericano de Resuscitation (CLAR).

Single rescuer adult basic life support: An advisory statement from the Basic Life Support Working Group of the International Liaison Committee on Resuscitation (ILCOR)

This document presents the consensus view of the Basic Life Support (BLS) Working Group of the International Liaison Committee on Resuscitation (ILCOR), which represents the world’s major resuscitation organizations (including the American Heart Association [AHA], the Australian Resuscitation Council, the European Resuscitation Council [ERC], the Heart and Stroke Foundation of Canada, and the Resuscitation Councils of Southern Africa). These advisory statements have evolved during 10 meetings of ILCOR from 1991 to the present. The scientific basis for the treatment of cardiac arrest has an active international literature.1 The purpose of creating these advisory statements is to take full advantage of international perspective and experience in the basic management of cardiac arrest. It is hoped that the “Sequence of Action” can be used as a template by individual national resuscitation organizations. This template should not, however, be considered a rigid standard. It is intended primarily to remove the many minor international differences in BLS education that have developed over the last 30 years, often without any basis in science. For example, if the current BLS guidelines of the ERC and the AHA are compared, most of the differences exist without any particular rationale and are based simply on quirks of historical practice. It is hoped that by removing these, BLS training can become as uniform as possible throughout the world. The process for the development of the advisory statements involved 1. Identification of major and minor differences between existing BLS guidelines.2 3 Minor differences mostly involved the use of words rather than any real differences of opinion about scientific content. They were resolved by arriving at a consensus. 2. Presentation of formal position papers on areas of major difference with an emphasis on available scientific evidence. The group attempted to reach consensus on items of controversy, but sometimes the …

RECORDINGS

RECORDINGS George Frideric Handel: ITALIAN CANTATAS Tu fedel? tu costante? . Mi palpita il cor, Alpestre monte, Tra le fiamme Emma Kirkby (soprano). The Academy of Ancient Music, directed by Christopher Hogwood (harpsichord) L'Oiseau-Lyre 414 473-1 (rec 1984) David Humphreys David Humphreys Search for other works by this author on: Oxford Academic Google Scholar Early Music, Volume 14, Issue 4, November 1986, Pages 609-a–609, https://doi.org/10.1093/earlyj/14.4.609-a Published: 01 November 1986