https://genoplivning.dk/wp-content/uploads/2013/07/european-resuscitation-council-guidelines-for-resuscitation-2010-section-4-adult-advanced-life-support.pdf

European Resuscitation Council Guidelines for Resuscitation 2010 Section 4 Adult advanced life support

European Resuscitation Council Guidelines for Resuscitation.

The goal of therapy for bradycardia or tachycardia is to rapidly identify and treat patients who are hemodynamically unstable or symptomatic due to the arrhythmia. Drugs or, when appropriate, pacing may be used to control unstable or symptomatic bradycardia. Cardioversion or drugs or both may be used to control unstable or symptomatic tachycardia. ACLS providers should closely monitor stable patients pending expert consultation and should be prepared to aggressively treat those with evidence of decompensation.

/pdf/part-8-adult-advanced-cardiovascular-life-support-2010-344vtppnij.pdf

Part 8: Adult Advanced Cardiovascular Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

In contrast to adults, cardiac arrest in infants and children does not usually result from a primary cardiac cause. More often it is the terminal result of progressive respiratory failure or shock, also called an asphyxial arrest. Asphyxia begins with a variable period of systemic hypoxemia, hypercapnea, and acidosis, progresses to bradycardia and hypotension, and culminates with cardiac arrest.1

Another mechanism of cardiac arrest, ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), is the initial cardiac rhythm in approximately 5% to 15% of pediatric in-hospital and out-of-hospital cardiac arrests;2,–,9 it is reported in up to 27% of pediatric in-hospital arrests at some point during the resuscitation.6 The incidence of VF/pulseless VT cardiac arrest rises with age.2,4 Increasing evidence suggests that sudden unexpected death in young people can be associated with genetic abnormalities in myocyte ion channels resulting in abnormalities in ion flow (see “Sudden Unexplained Deaths,” below).

Since 2010 marks the 50th anniversary of the introduction of cardiopulmonary resuscitation (CPR),10 it seems appropriate to review the progressive improvement in outcome of pediatric resuscitation from cardiac arrest. Survival from in-hospital cardiac arrest in infants and children in the 1980s was around 9%.11,12 Approximately 20 years later, that figure had increased to 17%,13,14 and by 2006, to 27%.15,–,17 In contrast to those favorable results from in-hospital cardiac arrest, overall survival to discharge from out-of-hospital cardiac arrest in infants and children has not changed substantially in 20 years and remains at about 6% (3% for infants and 9% for children and adolescents).7,9

It is unclear why the improvement in outcome from in-hospital cardiac arrest has occurred, although earlier recognition and management of at-risk patients on general inpatient units …

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.110.971101

Part 14: Pediatric Advanced Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

The study group.

Using ECG-analysis to quantify the effect of increasing pre-shock pauses in chest compressions on the probability of ROSC

Why is compression depth less consistent on humans than on manikins

Regular exercise is associated with reduced risk of cardiovascular disease. Paradoxically, an increased risk of sudden cardiac arrest (SCA) is documented during or immediately after exercise and in athletes compared to the nonathletic population. Our objective was to identify, through multiple sources, the total number of exercise‐related versus non‐exercise‐related SCA in the young population in Norway.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/sms.14400

A 3‐year population‐based study of exercise‐related sudden cardiac arrest among 12‐ to 50‐year‐old Norwegians

Aim Survival after cardiac arrest (CA) depends on the time-critical interventions summarised in the chain of survival –identification and alarming, cardiopulmonary resuscitation (CPR), defibrillation (if appropriate), and standardised post-arrest care. Voluntary, population based CA-registries have indicated significant improvements in survival associated with improved performance. Systematic improvement is based on repeated cycles of; measure to identify weakness, interventions to improve, and measure again to verify changes and effects. Strengthening CA-registries by making CA a mandatory reportable disease enables implementation. Methods Norway has a population of ~5.2 million. The Norwegian Cardiac Arrest Registry (NorCAR) restarted in 2013 with mandatory reporting in collaboration with Norwegian Cardiovascular Disease Registry. We measured “coverage” as the percentage of the Norwegian population served by the reporting EMS, and report incidence and survival rates per 100 000 person-years. Results Out of the 19 EMS health trusts in Norway, the number reporting to NorCAR (coverage) increased from 8 (47%) in 2013, to 17 (92%) in 2015, and by 2017 all EMS health trust are reporting. Incidence rates of ambulance-treated CA have increased: 41, 44, 48, and 51. Thirty-day survival rates from all-cause out-of-hospital CA in 2013, 2014, and 2015 were: 7.7 (19%), 5.9 (14%), 7.3 (15%), respectively. For first 2/3 of 2016 numbers are 6.8 (13%). Conclusion Establishing mandatory reporting is valuable when creating a population based registry. Regional variations inspire further work to improve reporting and quality. Close involvement of the local registrars and feeding back the results to local EMS are our main strategies. Conflict of interest None declared. Funding None declared.

https://bmjopen.bmj.com/content/bmjopen/7/Suppl_3/A9.1.full.pdf

Jo Kramer-Johansen

Papers

Using ECG-analysis to quantify the effect of increasing pre-shock pauses in chest compressions on the probability of ROSC

Why is compression depth less consistent on humans than on manikins

A 3‐year population‐based study of exercise‐related sudden cardiac arrest among 12‐ to 50‐year‐old Norwegians

22 Out-of-hospital cardiac arrest as a mandatory reportable disease – first experiences from norway

Stress and CPR quality in a full scale clinical cardiac arrest simulation compared to a traditional test—A randomised trial