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ERC Newsletter September 2019

Congress News:
One More Week to Ljubljana!

In one week, we hope to welcome you at Resuscitation 2019 in Ljubljana! With our theme of Controversies in Resuscitation, the ERC congress promises to deliver a fresh and exciting update on controversies in resuscitation science, guidelines and practice.

Registration online is still possible until 15 September. We hope to meet you there!

Register before 15 September

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General News:
World Restart A Heart 2019

We are counting down to the second global edition of World Restart A Heart on 16 October! You can now download promotional posters and flyers are already available in 28 languages on our ERC World Restart a Heart page. 

Keep an eye on this space as we keep you updated on all events taking place across the globe!

Find our posters and flyers here
Updated Course Rules Available

Our course rules have been updated and are now available on the ERC website, along with a document listing the main changes. 

Read our updated course rules

Around Europe:
State of the Future of Resuscitation Conference

On 14 and 15 October, Experts from around the world will discuss a wide range of topics related to advances in resuscitation science and clinical practice at the State of the Future of Resuscitation Conference in Paris.

The goal is to discuss ways to combine the best evidence and experience from the innovative work of the participants to optimize the systems-of-care approach to cardiac arrest.

Read more

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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:
Does psychological trauma affect resuscitation providers?

Article of the Month
Electroencephalography-based power spectra allow coma outcome prediction within 24 h of cardiac arrest
How accurate are pad positioning diagrams?

Correct defibrillation pad positioning optimises the chances of successful defibrillation. AEDs have pictures to guide untrained bystanders in correct pad positioning. Twenty untrained bystanders were presented with a total of 27 different pad placement diagrams (including one designed by the researchers). The sternal pad was placed an average of 6.0 mm cranial to, and 3.2 mm medial to, the optimal position. The apical pad was placed an average of 78.2 mm caudal to, and 59.3 mm medial to, the optimal position. All current defibrillation pad diagrams fail to achieve accurate defibrillation pad placement.

Comments: Especially the placement of the apical pad is a problem, as many instructors also experience during CPR training. The authors conclude that new diagrams  are needed on the pads. Also the change for the apical pad drawing to the craniocaudal position is mandatory. A study where the apical position is shown with a supplemental technique (e.g. to place one hand between the axilla and the pad) could help the bystander for better placement. 

Foster AG, Deakin CD. Accuracy of instructional diagrams for automated external defibrillator pad positioning. Resuscitation. 139(2019 Jun):282-8.

Read the full article
Defibrillation energy dose during paediatric cardiac arrest

To determine the initial defibrillation energy dose that is associated with sustained return of spontaneous circulation (ROSC) during paediatric cardiac arrest with ventricular fibrillation or pulseless ventricular tachycardia, no studies could report a statistically significant association between the initial defibrillation energy dose and the rate of sustained ROSC or survival. Defibrillation energy doses and thresholds varied according to the body weight and trended higher for infants. Clinicians should follow local consensus-based guidelines.

Comments: The energy dose for defibrillation in children is still not known because there are too many differencens between the different studies. The authors propose to further rely on local consensus-based guidelines. The ERC 2015 guidelines indicate that 4 J / kg is the ideal dose, above this the side effects increase: doses should be between 48J for children of 2 year until 120J for children of 12 year old (Monsieurs K et alii. Resuscitation. 95(2015):1-80)

Mercier E, Laroche E, Beck B, Le Sage N, Cameron PA, Émond M, Berthelot S, Mitra B, Ouellet-Pelletier J. Defibrillation energy dose during pediatric cardiac arrest: Systematic review of human and animal model studies. Resuscitation. 139 (2019 Jun):241-52.

Read the full article
Optimal Locations for Automatic External Defibrillators

Public access defibrillation (PAD) programs seek to optimise locations of AEDs to minimise the time from out-of-hospital cardiac arrest (OHCA) recognition to defibrillation. Most PAD programs have focused on static AED (S-AED) locations in high traffic areas. A new idea on locating publicly accessible AEDs on buses (B -AEDs) would increase publicly accessible AED coverage and reduce AED retrieval time relative to S-AEDs. The conclusion is that deployment of B-AEDs may improve AED coverage but not as a standalone deployment strategy.

Comments: OHCAs occur for around 25% in public places and for 75% in residential areas. This type of AED deployment needs to be taken in consideration. Different strategies (AED in police cars or AED locations at pharmacies - most people know the nearest pharmacy - and also this new idea about locating AEDs on buses) will not sufficiently increase the number of survivors as long as the number of (trained) bystander CPR and people capable of getting an AED increases, and vice versa. One cannot do without the other.

Hajari H, Salerno J, Weiss LS, Menegazzi JJ, Karimi H, Salcido DD. Simulating Public Buses as a Mobile Platform for Deployment of Publicly Accessible Automated External Defibrillators. Prehosp Emerg Care. 2019 May 24:1-8.

Read the full article here
Copyright © 2019 European Resuscitation Council, All rights reserved.

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