Resuscitation Council Guidelines 2015 – Key updates relating to Basic Life Support
Most of the changes relate to Advanced Life Support. For Basic Life Support we should be aware of the following.
Please visit the full summary here: https://www.resus.org.uk/covid-19-resources/covid-19-resources-general-public/resuscitation-council-uk-statement-covid-19
Paediatric life support
- The duration of delivering a breath is about 1 second, to coincide with adult practice.
- For chest compressions, depress the lower sternum by at least one-third the anterior-posterior diameter of the chest, or by 4 cm for the infant and 5 cm for the child.
The latter points are only if we are asked, we do not routinely teach this:
- The recommended compression: ventilation ratio for CPR remains at 3:1 for newborn resuscitation. Asynchronous compressions are not recommended.
In adults there is no evidence that a pre-defined period of CPR before defibrillation improves success rates. – this was being tested by some ambulance services
Education and implementation
- All school children should be taught how to perform CPR and should be made aware of how to use an AED.
- Ambulance services should have access to a national database of AEDs and their dispatchers should have specific training in how to provide clear and effective instructions to rescuers over the telephone.
- Frequent ‘low-dose’ training may be a beneficial method for providing CPR/AED retraining.
- The outcomes for candidates attending an e-ALS course are the same as those attending a conventional 2-day ALS course.
- High-fidelity manikins are not essential for life support courses.
- Life support courses should incorporate training in non-technical skills (e.g. leadership, team behaviour and communication) into their curricula.
- Healthcare systems should evaluate their processes to ensure those with a cardiac arrest have the best outcomes.
- Teams who manage patients in cardiac arrest should use data-driven performance-focused debriefing.
- Social media and innovative technology have vital roles to play in improving outcomes from cardiac arrest.
The Resuscitation Council (UK) Quality standards for cardiopulmonary resuscitation practice and training will help with the implementation of these guidelines in health care settings.
Guidelines 2015 do not define the only way that resuscitation should be achieved; they merely represent a widely accepted view of how resuscitation can be undertaken both safely and effectively. The publication of new treatment recommendations does not imply that current clinical care is either unsafe or ineffective.
The Resuscitation Council (UK) Guidelines undergo a major revision every 5 years (synchronised with the International Consensus on Cardiopulmonary Resuscitation Science Conferences and new ERC Guidelines) with occasional interim amendments to reflect very important new science. These interim amendments are generally made only if delaying guideline changes until a major revision is thought to put patients at risk. The decision to publish interim ‘advisory statements’ is made by the ILCOR delegates and although some experts advocate a more continuous process of science review, the next major review of these guidelines is likely to be in 2020.
The National Out of Hospital Cardiac Arrest Outcomes project www.warwick.ac.uk/ohcao measures patient, process and outcome variables from out-of-hospital-cardiac arrest in the UK. The project is run in collaboration with the National Ambulance Service Medical Directors Group with support from the British Heart Foundation, Resuscitation Council (UK) and University of Warwick. The project is designed to measure the epidemiology and outcomes from cardiac arrest and to serve as a national resource for continuous quality improvement initiatives for cardiac arrest.
The National Cardiac Arrest Audit (NCAA) https://ncaa.icnarc.org/ is an ongoing, national, comparative outcome audit of in-hospital cardiac arrests.4 It is a joint initiative between the Resuscitation Council (UK) and the Intensive Care National Audit & Research Centre (ICNARC) and is open to all acute hospitals in the UK and Ireland. The audit monitors and reports on the incidence of, and outcome from, in-hospital cardiac arrest in order to inform practice and policy. It aims to identify and foster improvements in the prevention, care delivery and outcomes from cardiac arrest.