Interpretation of the 2019 American Heart Association focused update on guidelines for cardiopulmonary resuscitation and emergency cardiovascular care: adult basic and advanced life support and first aid_West China Medical Journal

Authors：

 CAO Yu ^1,2 , HE Yarong ^1,2 , HAO Di ^1,2,3 , ZHENG Yue ^1,2 , MA Wen ^1,2,4 , ZHOU Tingyuan ^1,2,3 , LI Dongze ^1,2 , ZHOU Chao ^1,2,5 , LIU Junzhao ^1,2,3 , YE Sheng ^1,2,3 , LIU Bofu ^1,2 , ZHAO Yunuo ³ , YU Haifang ^1,2

1. Department of Emergency Medicine / Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Disaster Medical Center, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu, Sichuan 610207, P. R. China;
5. Department of Emergency Medicine, Chengdu Integrated Traditional Chinese and Western Medicine Hospital, Chengdu, Sichuan 610016, P. R. China;

Corresponding author：

CAO Yu, Email: yuyuer@126.com

Keywords：

Dispatcher- assisted cardiopulmonary resuscitation; Cardiac arrest center; Advanced airway; Vasopressor; Extracorporeal cardiopulmonary resuscitation; Presyncope

DOI：

10.7507/1002-0179.201911159

Video：

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Abstract Full text Figures/Tables Video References Cited by

American Heart Association updated the guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care in November 2019. This focused update incorporates the systematic review conducted by the International Liaison Committee on Resuscitation, an expert group consisting of hundreds of international resuscitation scientists, to identify the new evidence supporting the basic and advanced life support and first aid in emergency medical care. This focused update involves the life chain of CPR (dispatcher-assisted CPR and cardiac arrest centers), advanced cardiovascular life support (advanced airways, vasopressors, and extracorporeal CPR), and first aid for presyncope. This present review aims to interpret these updates by reviewing the literature and comparing the recommendations in this update with previous guidelines.

Citation： CAO Yu, HE Yarong, HAO Di, ZHENG Yue, MA Wen, ZHOU Tingyuan, LI Dongze, ZHOU Chao, LIU Junzhao, YE Sheng, LIU Bofu, ZHAO Yunuo, YU Haifang. Interpretation of the 2019 American Heart Association focused update on guidelines for cardiopulmonary resuscitation and emergency cardiovascular care: adult basic and advanced life support and first aid. West China Medical Journal, 2019, 34(11): 1217-1226. doi: 10.7507/1002-0179.201911159 Copy

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3. Kleinman ME, Goldberger ZD, Rea T, et al. 2017 American Heart Association focused update on adult basic life support and cardiopulmonary resuscitation quality: an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 2018, 137(1): e7-e13.
4. 曹钰, 李东泽. 2017 年美国心脏协会心肺复苏与心血管急救指南更新解读—成人基础生命支持和心肺复苏质量. 华西医学, 2017, 32(11): 1696-1698.
5. Song KJ, Shin SD, Park CB, et al. Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: a before-after population-based study. Resuscitation, 2014, 85(1): 34-41.
6. Goto Y, Maeda T, Goto Y. Impact of dispatcher-assisted bystander cardiopulmonary resuscitation on neurological outcomes in children with out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. J Am Heart Assoc, 2014, 3(3): e000499.
7. Fukushima H, Panczyk M, Hu C, et al. Description of abnormal breathing is associated with improved outcomes and delayed telephone cardiopulmonary resuscitation instructions. J Am Heart Assoc, 2017, 6(9): e005058.
8. Vaillancourt C, Verma A, Trickett J, et al. Evaluating the effectiveness of dispatch-assisted cardiopulmonary resuscitation instructions. Acad Emerg Med, 2007, 14(10): 877-883.
9. Harjanto S, Na MX, Hao Y, et al. A before after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore. Resuscitation, 2016, 102: 85-93.
10. Takahashi H, Sagisaka R, Natsume Y, et al. Does dispatcher-assisted CPR generate the same outcomes as spontaneously delivered bystander CPR in Japan?. Am J Emerg Med, 2018, 36(3): 384-391.
11. Wu Z, Panczyk M, Spaite DW, et al. Telephone cardiopulmonary resuscitation is independently associated with improved survival and improved functional outcome after out-of-hospital cardiac arrest. Resuscitation, 2018, 122: 135-140.
12. Chang I, Lee SC, Shin SD, et al. Effects of dispatcher-assisted bystander cardiopulmonary resuscitation on neurological recovery in paediatric patients with out-of-hospital cardiac arrest based on the pre-hospital emergency medical service response time interval. Resuscitation, 2018, 130: 49-56.
13. Shah M, Bartram C, Irwin K, et al. Evaluating dispatch-assisted CPR using the CARES registry. Prehosp Emerg Care, 2018, 22(2): 222-228.
14. Rea TD, Eisenberg MS, Culley LL, et al. Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest. Circulation, 2001, 104(21): 2513-2516.
15. Ro YS, Shin SD, Lee YJ, et al. Effect of dispatcher-assisted cardiopulmonary resuscitation program and location of out-of-hospital cardiac arrest on survival and neurologic outcome. Ann Emerg Med, 2017, 69(1): 52-61.
16. Japanese Circulation Society Resuscitation Science Study Group. Chest-compression-only bystander cardiopulmonary resuscitation in the 30:2 compression-to-ventilation ratio era. Nationwide observational study. Circ J, 2013, 77(11): 2742-2750.
17. Viereck S, Møller TP, Ersbøll AK, et al. Recognising out-of-hospital cardiac arrest during emergency calls increases bystander cardiopulmonary resuscitation and survival. Resuscitation, 2017, 115: 141-147.
18. Yeung J, Matsuyama T, Bray J, et al. Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest?-A systematic review. Resuscitation, 2019, 137: 102-115.
19. Donnino MW, Rittenberger JC, Gaieski DA, et al. The development and implementation of cardiac arrest centers. Resuscitation, 2011, 82(8): 974-978.
20. Field JM, Hazinski MF, Sayre MR, et al. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 2010, 122(18 Suppl 3): S640-S656.
21. Matsuyama T, Kiyohara K, Kitamura T, et al. Hospital characteristics and favourable neurological outcome among patients with out-of-hospital cardiac arrest in Osaka, Japan. Resuscitation, 2017, 110: 146-153.
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25. Patterson T, Perkins GD, Joseph J, et al. A randomised trial of expedited transfer to a cardiac arrest centre for non-ST elevation ventricular fibrillation out-of-hospital cardiac arrest: the ARREST pilot randomised trial. Resuscitation, 2017, 115: 185-191.
26. Spaite DW, Bobrow BJ, Stolz U, et al. Statewide regionalization of postarrest care for out-of-hospital cardiac arrest: association with survival and neurologic outcome. Ann Emerg Med, 2014, 64(5): 496-506.
27. Kragholm K, Malta Hansen C, Dupre ME, et al. Direct transport to a percutaneous cardiac intervention center and outcomes in patients with out-of-hospital cardiac arrest. Circ Cardiovasc Qual Outcomes, 2017, 10(6): e003414.
28. Jabre P, Penaloza A, Pinero D, et al. Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest a randomized clinical trial. JAMA, 2018, 319(8): 779-787.
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31. Wang HE, Schmicker RH, Daya MR, et al. Effect of a strategy of initial laryngeal tube insertion vs endotracheal intubation on 72-hour survival in adults with out-of-hospital cardiac arrest: a randomized clinical trial. JAMA, 2018, 320(8): 769-778.
32. Holmberg MJ, Issa MS, Moskowitz A, et al. Vasopressors during adult cardiac arrest: a systematic review and meta-analysis. Resuscitation, 2019, 139: 106-121.
33. Perkins GD, Ji C, Deakin CD, et al. A randomized trial of epinephrine in out-of-hospital cardiac arrest. N Engl J Med, 2018, 379(8): 711-721.
34. Perkins GD, Kenna C, Ji C, et al. The effects of adrenaline in out of hospital cardiac arrest with shockable and non-shockable rhythms: findings from the PACA and PARAMEDIC-2 randomised controlled trials. Resuscitation, 2019, 140: 55-63.
35. Soar J, Nolan JP, Böttiger BW, et al. European Resuscitation Council guidelines for resuscitation 2015: section 3. Adult advanced life support. Resuscitation, 2015, 95: 100-147.
36. Callaway CW, Soar J, Aibiki M, et al. Part 4: advanced life support: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation, 2015, 132(16 Suppl 1): S84-S145.
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West China Medical Journal

Interpretation of the 2019 American Heart Association focused update on guidelines for cardiopulmonary resuscitation and emergency cardiovascular care: adult basic and advanced life support and first aid

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