The Resuscitation Council (UK) 2015 guidelines have followed the same development process as in 2010; the International Committee on Resuscitation (ILCOR) 2015 Consensus on Science and Treatment Recommendations along with focused literature reviews are used to construct the European Resuscitation Council’s (ERC) guidelines and these form the basis for the UK guidelines. The process used by the RC (UK) to create and develop the guidelines has National Institute for Health and Care Excellence (NICE) accreditation.
For the first time in recent years, the 2015 guidelines do not include any significant changes to core interventions or processes. The science would seem to suggest that what we are doing is right, but not necessarily consistently or to a high enough standard. As a result, the new guidelines emphasise the importance of implementation and quality assurance in order to try and improve patient outcomes.
Out of hospital, there should be increased public involvement in recognition of cardiac arrest, calling the emergency services, starting CPR, locating and using an AED as quickly as possible. Healthcare professionals can help with this by offering and supporting training initiatives where ever appropriate, particularly to school children.
Survival following an in-hospital cardiac arrest has remained just below 20% for a number of years. To try and increase this, the new in-hospital guidelines identify key areas for improvement; those responsible for resuscitation should plan their actions and agree roles and responsibilities before attending an arrest and once there, high quality chest compressions must be performed with minimal interruptions. During defibrillation, proper preparation and team leadership should ensure chest compressions are continued while the defibrillator is charged, and interrupted for less than 5 seconds while the shock is delivered. Chest compressions must be resumed immediately, there is no indication for a delay to check for a pulse.
Until now, monitoring during a cardiac arrest has been mainly by clinical assessment, however there is now good evidence to show the value of waveform capnography. It can provide evidence that a tracheal tube is in the trachea, prevent hyperventilation, inform the quality of chest compressions and give an early sign of return of a spontaneous circulation (ROSC), which in turn may prevent the patient receiving an unnecessary and potentially harmful dose of adrenaline.
Finally, the Resuscitation Council (UK) wants to outline the importance of decisions surrounding end-of-life care and in particular decisions about whether or not to attempt cardiopulmonary resuscitation. Such decisions and conversations about resuscitation with patients and those close to them are essential to ensure that dying people have the opportunity of death with dignity.
In conjunction with the 2015 Guidelines, the Resuscitation Council (UK) has developed a new version of the iResus app. This free tool allows healthcare professionals to access the latest algorithms from the guidelines quickly and easily using any tablet or mobile device. The app is lightweight and does not require an internet connection to function. It can be downloaded on October 16 via the Apple app store or Google play.
‘The Resuscitation Council (UK) sees the 2015 Guidelines not just as clinical tools, but as an expression of ‘Community, Quality and Compassion‘, to try to improve the outcome for those who suffer a cardiac arrest and provide care and support for those close to death’ explains Dr Carl Gwinnutt, President of the Resuscitation Council (UK).
Notes to Editor:
•The full 2015 UK Resuscitation Guidelines can be found on our website from 11am on 15 October 2015 - www.resus.org.uk/resuscitation-guidelines
There are video summaries of all chapters.
•To achieve its objective, the Resuscitation Council (UK) has the following aims:
To encourage research into methods of resuscitation
To study resuscitation teaching techniques
To establish appropriate guidelines for resuscitation procedures
To promote the teaching of resuscitation as established in the guidelines
To establish and maintain standards for resuscitation
To foster good working relations between all organisations involved in resuscitation and to produce and Publish training aids and other literature concerned with the organisation of resuscitation and its teaching
•In 2012 the National Institute for Health and Care Excellence (NICE) awarded the RC (UK) accreditation for the resuscitation Guidelines 2010. Three years on the RC (UK) applied for and has received NICE accreditation for the process used to assemble and produce all guideline documents.
•For more information on this release, please contact the Resuscitation Council (UK) press office on 0207 391 0703 or out of hours on 07506 374945.