Top Things to Know: 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary
Published: November 09, 2023
Prepared by Amber Hoover MSN, RN
- There are new treatment recommendations for key prehospital interventions for drowning-related cardiac arrest.
- AED delivery by drones continues to be a hot topic, but there is currently insufficient evidence for a recommendation.
- Simulation trials show that wearing PPE does not impact CPR quality.
- Cardiac arrest patients with shockable rhythms refractory to standard defibrillation attempts may benefit from the use of alternative defibrillation techniques (double sequential defibrillation or vector change defibrillation).
- Calcium should not be routinely administered during cardiac resuscitation.
- Consider ECPR for Pediatric IHCA Refractory to CPR, although there is insufficient evidence for use following OHCA.
- Following pediatric cardiac arrest, good neurological outcome prediction can be supported with clinical examination of pupillary response, use of blood biomarkers, MRI neuroimaging and electroencephalography (EEG) testing.
- An extensive systematic review identified that hypothermia was common among infants born in both hospitals and homes, even in tropical environments. Among the comparator subgroups it was identified that active warming techniques should be used with caution while monitoring carefully in case of hyperthermia.
- While pulse oximeters may be valuable adjuncts for first aid providers, their use should not supersede or replace physical assessment. First aid providers should be trained in their use and how to interpret the results including understand their limitations.
- When administering supplemental oxygen to patients with known COPD, first aid providers should titrate the supplemental oxygen to maintain an oxygen saturation by pulse oximetry between 88% and 92%.
- Family members should have the option to be present during adult resuscitation, acknowledging that providers are often not able to control this. Policies or protocols about family presence during resuscitation should guide and support healthcare professional decisions. Healthcare providers need education about family presence during adult cardiac arrest resuscitation (management of the stress and own response to such situations, family distress)
- For the stepwise approach to skills training in resuscitation, no evidence was found that the four-step approach as proposed by Walker & Peyton was superior to other approaches in resuscitation skills teaching. However, stepwise teaching of skills is well-founded in educational theory and should remain a cornerstone of instruction.
Citation
Berg KM, Bray JE, Ng K-C, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, et al. 2023 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science withtreatment recommendations: summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support;Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces [published online aheadof print November 9, 2023]. Circulation. doi: 10.1161/CIR.0000000000001179