Cardiology
Cardiopulmonary arrest & resuscitation
Cardiac arrest is a time-critical emergency that requires rapid, evidence-based interventions to improve survival rates and neurological outcomes. High-quality cardiopulmonary resuscitation (CPR), defibrillation, and post-resuscitation care are essential components of advanced life support (ALS).
This section covers:
- Updated advanced life support (ALS) guidelines, detailing best practices for in-hospital and out-of-hospital cardiac arrest management.
- Cardiac arrest in special circumstances, including adaptations for cases caused by hypoxia, trauma, anaphylaxis, sepsis, hypothermia, and electrolyte imbalances.
- Post-resuscitation care, focusing on hemodynamic optimization, neurological assessment, and targeted temperature management to enhance patient recovery.
By following evidence-based guidelines and resuscitation protocols, healthcare providers can ensure effective interventions, reduce complications, and optimize long-term outcomes for patients experiencing cardiac arrest.
Advanced life support guidelines
Adult advanced life support (ALS) / cardiopulmonary resuscitation (CPR)
European Resuscitation Council Guidelines 2021: Adult advanced life support
Jasmeet Soar et al., Resuscitation (2021)
What’s inside
This article presents updated guidelines for adult advanced life support, encompassing advanced interventions following basic life support and the use of an automated external defibrillator.
Why it’s relevant
The guidelines offer evidence-based recommendations for healthcare professionals, aiming to enhance patient outcomes during cardiac emergencies.
Key focus
- Prevention and ALS treatments for both in-hospital and out-of-hospital cardiac arrest
- Integration of new evidence into resuscitation practices
- Emphasis on high-quality resuscitation education for healthcare providers
Takeaway
The 2021 ERC guidelines provide essential updates to ALS protocols, supporting healthcare professionals in delivering effective resuscitation and improving survival rates in cardiac arrest cases.
Cardiac arrest in special circumstances
See elsewhere for CPR of the newborn, paediatric and pregnant.
Cardiac arrest in special circumstances
European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances
Carsten Lott et al., Resuscitation (2021)
What’s inside
This article provides guidelines on modifications required to basic and advanced life support for preventing and treating cardiac arrest in special circumstances, including specific causes such as hypoxia, trauma, anaphylaxis, sepsis, electrolyte disorders, hypothermia, and hyperthermia.
Why it’s relevant
The guidelines offer evidence-based recommendations tailored to unique clinical scenarios, assisting healthcare professionals in effectively managing cardiac arrest cases that deviate from typical presentations.
Key focus
- Adaptations for cardiac arrest resulting from hypoxia, trauma, anaphylaxis, sepsis, and electrolyte imbalances
- Management strategies for hypothermia, hyperthermia, and other environmental factors
- Special considerations for cardiac arrest during pregnancy and in patients with specific medical conditions
Takeaway
The 2021 ERC guidelines equip healthcare providers with critical insights and protocols to address cardiac arrest in diverse and challenging situations, enhancing patient care across various emergencies.
Post-resuscitation care & prognostication
Post-resuscitation care
European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care
Jerry P. Nolan et al., Resuscitation (2021)
What’s inside
This article provides comprehensive guidelines on post-resuscitation care for adults, focusing on interventions and strategies to optimize patient outcomes following the return of spontaneous circulation after cardiac arrest.
Why it’s relevant
The guidelines offer evidence-based recommendations to healthcare professionals, aiming to improve survival rates and neurological outcomes in patients who have been resuscitated after cardiac arrest.
Key focus
- Hemodynamic optimization and monitoring
- Neurological assessment and prognostication
- Ventilation and oxygenation targets
- Coronary reperfusion and other interventional procedures
For updated recommendations on temperature control and management strategies, please refer to the ERC-ESICM guideline update (see below).
Takeaway
The 2021 ERC and ESICM guidelines provide essential updates on post-resuscitation care protocols, supporting healthcare professionals in delivering effective treatment to improve survival and neurological outcomes in patients following cardiac arrest.
Temperature control after cardiac arrest
ERC-ESICM guidelines on temperature control after cardiac arrest in adults
Claudio Sandroni et al., Intensive Care Medicine (2022)
What’s inside
This article provides updated guidelines on temperature control for adults who are comatose after resuscitation from cardiac arrest, offering evidence-based recommendations to optimize patient outcomes.
Why it’s relevant
The guidelines address recent evidence and provide clear directives for healthcare professionals on managing body temperature in post-cardiac arrest patients, aiming to improve survival rates and neurological outcomes.
Key focus
- Continuous monitoring of core temperature
- Active prevention of fever (temperature > 37.7 °C) for at least 72 hours
- Recommendations against the routine use of prehospital cooling with rapid infusion of large volumes of cold intravenous fluids immediately after return of spontaneous circulation
- Guidance on not actively rewarming comatose patients with mild hypothermia to achieve normothermia
Takeaway
The 2022 ERC-ESICM guidelines offer crucial updates on temperature management strategies for post-cardiac arrest care, assisting healthcare providers in implementing best practices to enhance patient recovery.