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ERC Newsletter February 2020

General News:
Update on COVID-19 (Coronavirus)

The ERC is keeping a close eye on the developments surrounding COVID-19 (the coronavirus). We are currently maintaining all of our upcoming congresses and events. Should that change, we will announce it here.

For upcoming ERC courses, we advise all national resuscitation councils and course centers to follow the recommendations of the national and international public health authorities. Our paramount concern is the health and wellbeing of all participants and ERC instructors, and we continue to follow the recommendations as they evolve.

Click here for more information on basic protective measures against COVID-19
 
Congress News:
Resuscitation 2020 Unveils Scientific Programme

Here it is! The Scientific Programme for the 2020 Guidelines Congress in Manchester is now available. Featuring everything you need to know about the new ERC Guidelines and much more! Check it out and take advantage of our early bird rates by registering now.

Find the scientific programme here

Register now and save up to €70!
 

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Interesting Reading:
This section of the newsletter is to highlight articles that we found interesting. If you are an ERC member you can access the entire texts of Resuscitation journal articles by first logging in on CoSy and then following the links below. With thanks to
Walter Renier for providing the selection.
Each month you can download one free Article of the Month and an Editorial of the Month from Resuscitation.

Editorial of the Month:
A fork in the road after STEMI: Rapid recovery and discharge or cardiac arrest and high mortality

Article of the Month
Improvement of consciousness before initiating targeted temperature management
Improving communication during cardiac arrest

In order to reduce chest compression (CC) pauses during In-hospital CPR, a standardised communication model was developed and compared to closed-loop communication. The standardised communication group showed shorter chest compression pauses for defibrillation, intubation, and rhythm checks without increasing frustration index or mental demand compared to current best practice, closed loop communication.

Comments: This in-hospital communication model, well-structured and explained in the paper, should be studied either in a simulated or in a real situation to observe the improvement, since an out-of-hospital situation is more difficult to control than in-hospital interventions. As the authors propose, similar models should be trained in advanced courses. The questions remains if one should wait until more evidence is found.  

Lauridsen KG, Watanabe I, Løfgren B, Cheng A, Duval-Arnould J, Hunt EA, Good GL et al. Standardising Communication to improve in-hospital cardiopulmonary resuscitation. Resuscitation. 2020 Feb 1;147:73-80.


Read the full article
Does alerting mobile rescuers improve outcomes of Out-of-Hospital Cardiac Arrest?

This study compares the differences between CPR-trained volunteers (Mobile Rescuers), Emergency Medical Service (EMS) teams (both alerted in the same time) and lay bystanders who initiated CPR. The emergency response time and hospital discharge was significantly shorter for Mobile Rescuers. Return of Spontaneous Circulation (ROSC) was more frequent with Mobile Rescuers but statistical significance was narrowly missed (p = 0.056). Good neurological outcomes were similar in all groups, although the authors concluded that neurological outcomes after Out-of-Hospital Cardiac Arrest (OHCA) might improve by Mobile Rescuers’ response time and might more frequently lead to ROSC.

Comments: This German study confirmed already-known results of the impact of CPR-trained people who can be called by the emergency service dispatcher, as is incorporated in some European regions. EMS teams took over all cases before arrival at the hospital. Results can be affected by the one who started CPR: lay bystanders before Mobile Rescuers or EMS team before arrival of a Mobile Rescuer. Higher hospital discharge is certainly influenced by the call-to-CPR time as is demonstrated in the study about the more frequent presence of VF, as EMS teams arrive later to the scene. CPR initiated by trained people compared to lay bystanders leads to more ROSC and is an incentive to train more lay people.

Stroop R, Kerner T, Strickmann B, Hensel M. Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study. Resuscitation. 2020 Feb 1;147:57-64


Read the full article
Which factors predict neurological outcome in children?

To identify early clinical predictors of neurologica outcome in children with asphyxial out-of-hospital cardiac arrest (OHCA) treated with therapeutic hypothermia, a retrospective cohort study was conducted between January 2010 and June 2018. They found that 40% of the children had underlying disorders. The overall 1-month survival rate was 36%, but only 12% of the patients had favourable outcomes (PCPC ≤ 2). An initial lactate level of ≤ 80 mg/dL and a Glasgow coma scale (GCS) score of 5-8 were significantly associated with favourable 6-month neurological outcomes.

Comments: Authors confirmed that some items need more investigation: what is the importance of the underlying (respiratory or neurological) disorder in children? What is the influence of the predictors: a GCS of 5-8, easy to determine in an OHCA cardiopulmonary arrest, lactate levels or maybe also other blood tests,  importance of the first documented arrest rhythm (asystole and bradycardia/pulseless electrical activity)? Important in this study is that in 55% of the cases bystander CPR was started.

Lin JJ, Lin YJ, Hsia SH, Kuo HC, Wang HS, Hsu MH, Chiang MC et alii. Early Clinical Predictors of Neurological Outcome in Children With Asphyxial Out-of-Hospital Cardiac Arrest Treated With Therapeutic Hypothermia. Front Pediatr. 2020 Jan 17;7:534.


Read the full article here
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