ERC Guidelines for resuscitation 2010

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Journal: Resuscitation

European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary

Jerry P. Nolan, Jasmeet Soar, David A. Zideman, Dominique Biarent, Leo L. Bossaert, Charles Deakin, Rudolph W. Koster, Jonathan Wyllie, Bernd Böttiger, on behalf of the ERC Guidelines Writing Group 1 .

Published online 19 October 2010, pages 1219 - 1276

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Introduction

The publication of these European Resuscitation Council (ERC) Guidelines for cardiopulmonary resuscitation (CPR) updates those that were published in 2005 and maintains the established 5-yearly cycle of guideline changes. 1 x J. Nolan. European Resuscitation Council Guidelines for resuscitation 2005. Section 1. Introduction. Resuscitation 67 (Suppl. 1) (2005) (S3 - S6) Like the previous guidelines, these 2010 guidelines are based on the most recent International Consensus on CPR Science with Treatment Recommendations (CoSTR), 2 x Nolan JP, Hazinski MF, Billi JE, et al. International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 1. Executive Summary. Resuscitation; doi:10.1016/j.resuscitation.2010.08.002 , in press. which incorporated the results of systematic reviews of a wide range of topics relating to CPR. Resuscitation science continues to advance, and clinical guidelines must be updated regularly to reflect these developments and advise healthcare providers on best practice. In between the 5-yearly guideline updates, interim scientific statements can inform the healthcare provider about new therapies that might influence outcome significantly. 3 x J.P. Nolan, R.W. Neumar, C. Adrie, et al.. Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation 79 (2008) (350 - 379)

This executive summary provides the essential treatment algorithms for the resuscitation of children and adults and highlights the main guideline changes since 2005. Detailed guidance is provided in each of the remaining nine sections, which are published as individual papers within this issue of Resuscitation. The sections of the 2010 guidelines are:

  • 1. Executive summary;
  • 2. Adult basic life support and use of automated external defibrillators; 4 x R.W. Koster, M.A. Baubin, A. Caballero, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 81 (2010) (1277 - 1292)
  • 3. Electrical therapies: automated external defibrillators, defibrillation, cardioversion and pacing; 5 x C.D. Deakin, J.P. Nolan, K. Sunde, R.W. Koster. European Resuscitation Council Guidelines for Resuscitation 2010. Section 3. Electrical therapies: automated external defibrillators, defibrillation, cardioversion and pacing. Resuscitation 81 (2010) (1293 - 1304)
  • 4. Adult advanced life support; 6 x C.D. Deakin, J.P. Nolan, J. Soar, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 4. Adult advanced life support. Resuscitation 81 (2010) (1305 - 1352)
  • 5. Initial management of acute coronary syndromes; 7 x H.R. Arntz, L. Bossaert, N. Danchin, N. Nikolaou. European Resuscitation Council Guidelines for Resuscitation 2010. Section 5. Initial management of acute coronary syndromes. Resuscitation 81 (2010) (1353 - 1363)
  • 6. Paediatric life support; 8 x D. Biarent, R. Bingham, C. Eich, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 6. Paediatric life support. Resuscitation 81 (2010) (1364 - 1387)
  • 7. Resuscitation of babies at birth; 9 x J. Wyllie, S. Richmond. European Resuscitation Council Guidelines for Resuscitation 2010. Section 7. Resuscitation of babies at birth. Resuscitation 81 (2010) (1388 - 1398)
  • 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution; 10 x J. Soar, G.D. Perkins, G. Abbas, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation 81 (2010) (1399 - 1431)
  • 9. Principles of education in resuscitation; 11 x J. Soar, K.G. Monsieurs, J. Ballance, et al.. European Resuscitation Council Guidelines for Resuscitation. Section 9. Principles of education in resuscitation. Resuscitation 81 (2010) (1432 - 1442)
  • 10. The ethics of resuscitation and end-of-life decisions. 12 x F.K. Lippert, V. Raffay, M. Georgiou, P.A. Steen, L. Bossaert. European Resuscitation Council Guidelines for Resuscitation 2010. Section 10. The ethics of resuscitation and end-of-life decisions. Resuscitation 81 (2010) (1443 - 1449)

The guidelines that follow do not define the only way that resuscitation can be delivered; they merely represent a widely accepted view of how resuscitation should be undertaken both safely and effectively. The publication of new and revised treatment recommendations does not imply that current clinical care is either unsafe or ineffective.

References

Label Authors Title Source Year
1

References in context

  • The publication of these European Resuscitation Council (ERC) Guidelines for cardiopulmonary resuscitation (CPR) updates those that were published in 2005 and maintains the established 5-yearly cycle of guideline changes.1 Like the previous guidelines, these 2010 guidelines are based on the most recent International Consensus on CPR Science with Treatment Recommendations (CoSTR),2 which incorporated the results of systematic reviews of a wide range of topics relating to CPR.
    Go to context

J. Nolan. European Resuscitation Council Guidelines for resuscitation 2005. Section 1. Introduction. Resuscitation 67 (Suppl. 1) (2005) (S3 - S6) 2005
2

References in context

  • The publication of these European Resuscitation Council (ERC) Guidelines for cardiopulmonary resuscitation (CPR) updates those that were published in 2005 and maintains the established 5-yearly cycle of guideline changes.1 Like the previous guidelines, these 2010 guidelines are based on the most recent International Consensus on CPR Science with Treatment Recommendations (CoSTR),2 which incorporated the results of systematic reviews of a wide range of topics relating to CPR.
    Go to context

  • The International Liaison Committee on Resuscitation (ILCOR) includes representatives from the American Heart Association (AHA), the European Resuscitation Council (ERC), the Heart and Stroke Foundation of Canada (HSFC), the Australian and New Zealand Committee on Resuscitation (ANZCOR), Resuscitation Council of Southern Africa (RCSA), the Inter-American Heart Foundation (IAHF), and the Resuscitation Council of Asia (RCA).
    Go to context

  • During the 3 years leading up to this conference, 356 worksheet authors reviewed thousands of relevant, peer-reviewed publications to address 277 specific resuscitation questions, each in standard PICO (Population, Intervention, Comparison Outcome) format.2 Each science statement summarised the experts’ interpretation of all relevant data on a specific topic and consensus draft treatment recommendations were added by the relevant ILCOR task force.
    Go to context

  • During the 3 years leading up to this conference, 356 worksheet authors reviewed thousands of relevant, peer-reviewed publications to address 277 specific resuscitation questions, each in standard PICO (Population, Intervention, Comparison Outcome) format.2 Each science statement summarised the experts’ interpretation of all relevant data on a specific topic and consensus draft treatment recommendations were added by the relevant ILCOR task force.
    Go to context

Nolan JP, Hazinski MF, Billi JE, et al. International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 1. Executive Summary. Resuscitation; doi:10.1016/j.resuscitation.2010.08.002 , in press.
3

References in context

  • The publication of these European Resuscitation Council (ERC) Guidelines for cardiopulmonary resuscitation (CPR) updates those that were published in 2005 and maintains the established 5-yearly cycle of guideline changes.1 Like the previous guidelines, these 2010 guidelines are based on the most recent International Consensus on CPR Science with Treatment Recommendations (CoSTR),2 which incorporated the results of systematic reviews of a wide range of topics relating to CPR.
    Go to context

  • The actions linking the victim of sudden cardiac arrest with survival are called the Chain of Survival (Fig. 1.1).
    Go to context

  • The post-cardiac arrest syndrome, which comprises post-cardiac arrest brain injury, post-cardiac arrest myocardial dysfunction, the systemic ischaemia/reperfusion response, and the persistent precipitating pathology, often complicates the post-resuscitation phase.3 The severity of this syndrome will vary with the duration and cause of cardiac arrest.
    Go to context


  • Go to context

J.P. Nolan, R.W. Neumar, C. Adrie, et al.. Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation 79 (2008) (350 - 379) 2008
4

References in context

 R.W. Koster, M.A. Baubin, A. Caballero, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 81 (2010) (1277 - 1292) 2010
5

References in context

 C.D. Deakin, J.P. Nolan, K. Sunde, R.W. Koster. European Resuscitation Council Guidelines for Resuscitation 2010. Section 3. Electrical therapies: automated external defibrillators, defibrillation, cardioversion and pacing. Resuscitation 81 (2010) (1293 - 1304) 2010
6

References in context


  • Go to context

  • The actions linking the victim of sudden cardiac arrest with survival are called the Chain of Survival (Fig. 1.1).
    Go to context

  • When defibrillation is warranted, give a single shock and resume chest compressions immediately following the shock.
    Go to context

  • Consider pacing in patients with symptomatic bradycardia refractory to anti-cholinergic drugs or other second line therapy (see Advanced life support).6 Immediate pacing is indicated especially when the block is at or below the His-Purkinje level.
    Go to context

  • Treat life-threatening tachyarrhythmias with cardioversion according to the peri-arrest arrhythmia guidelines (see Advanced life support).6 This includes correction of electrolyte and acid-base abnormalities.
    Go to context

C.D. Deakin, J.P. Nolan, J. Soar, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 4. Adult advanced life support. Resuscitation 81 (2010) (1305 - 1352) 2010
7

References in context

 H.R. Arntz, L. Bossaert, N. Danchin, N. Nikolaou. European Resuscitation Council Guidelines for Resuscitation 2010. Section 5. Initial management of acute coronary syndromes. Resuscitation 81 (2010) (1353 - 1363) 2010
8

References in context


  • Go to context

  • For children, rescuers should be encouraged to use whichever adult sequence they have been taught, as outcome is worse if they do nothing.
    Go to context

D. Biarent, R. Bingham, C. Eich, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 6. Paediatric life support. Resuscitation 81 (2010) (1364 - 1387) 2010
9

References in context

 J. Wyllie, S. Richmond. European Resuscitation Council Guidelines for Resuscitation 2010. Section 7. Resuscitation of babies at birth. Resuscitation 81 (2010) (1388 - 1398) 2010
10

References in context


  • Go to context

  • If VF/VT occurs during cardiac catheterisation or in the early post-operative period following cardiac surgery (when chest compressions could disrupt vascular sutures), consider delivering up to three-stacked shocks before starting chest compressions (see Special circumstances).10 This three-shock strategy may also be considered for an initial, witnessed VF/VT cardiac arrest if the patient is already connected to a manual defibrillator.
    Go to context


  • Go to context

  • Potential causes or aggravating factors for which specific treatment exists must be considered during any cardiac arrest.
    Go to context

  • The World Health Organisation (WHO) estimates that, worldwide, drowning accounts for approximately 450,000 deaths each year and drowning is a common cause of accidental death in Europe.
    Go to context

  • The patient with severe asthma requires aggressive medical management to prevent deterioration.
    Go to context

J. Soar, G.D. Perkins, G. Abbas, et al.. European Resuscitation Council Guidelines for Resuscitation 2010. Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation 81 (2010) (1399 - 1431) 2010
11

References in context

 J. Soar, K.G. Monsieurs, J. Ballance, et al.. European Resuscitation Council Guidelines for Resuscitation. Section 9. Principles of education in resuscitation. Resuscitation 81 (2010) (1432 - 1442) 2010
12

References in context

 F.K. Lippert, V. Raffay, M. Georgiou, P.A. Steen, L. Bossaert. European Resuscitation Council Guidelines for Resuscitation 2010. Section 10. The ethics of resuscitation and end-of-life decisions. Resuscitation 81 (2010) (1443 - 1449) 2010

Article information

PII: S0300-9572(10)00447-8
DOI: 10.1016/j.resuscitation.2010.08.021
© 2010 Published by Elsevier B.V.

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