Part 1: Introduction to the International Guidelines 2000 for CPR and ECC: A Consensus on Science
Section snippets
International Guidelines
This publication presents the conclusions of the International Guidelines 2000 Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). We have achieved a long-term goal: to create valid, widely accepted international resuscitation guidelines based on international science and produced by international resuscitation experts. The Guidelines 2000 Conference was more than an update of previous recommendations for CPR and ECC published by the AHA (in 1974 [1], 1980
Historical Perspective
During the 40 years since the introduction of modern CPR and ECC there have been many advances in ECC for cardiac arrest victims. These interventions have restored the lives of many people when breathing has ceased and the heart has stopped. For those with preserved neurological function and treatable cardiopulmonary disease, a lengthy, vigorous, and high-quality life may often follow.
Until 1960 successful resuscitation was limited to victims of respiratory arrest. Emergency thoracotomy with
Achievements and Recommendations from Previous Guideline Conferences
The Guidelines 2000 Conference must not be considered an American conference or an AHA conference. The most valid descriptive term is international. This conference, planned and organized by a liaison of the world's major resuscitation councils, embraced a wide range of topics and issues. Each previous conference also established important milestones (Table 1).
Beginning with the original 1966 conference of the National Academy of Sciences-National Research Council, every AHA conference has
Scientific Advances: ILCOR, Stroke, Acute Coronary Syndromes, and Public Access Defibrillation
Resuscitation is an active and exciting area of research. By 1997 ECC leaders recognized the need to incorporate new scientific advances into international guidelines in a timely fashion. The member councils of the International Liaison Committee on Resuscitation (ILCOR) provided strong support for this idea. As an international ‘council of councils,’ ILCOR embarked on a 2-year plan to develop a series of ‘advisory statements.’ These statements pursued 2 objectives: to identify all differences
2000–The First International Conference on Guidelines for CPR and ECC
The objectives of the Guidelines 2000 Conference were to
- 1.
Fulfill the 1992 goal of producing the first (a) international guidelines (b) supported by international science and (c) developed by international collaboration. A related goal was to have >50% of the conference participants affiliated with non-US organizations.
- 2.
Establish ILCOR as the committee responsible for coordinating the international science review and communicating the international science conclusions via the recurring ILCOR
Evidence-Based Resuscitation Guidelines
Conference participants used evidence-based criteria to identify, evaluate, and appraise scientific publications and to propose needed changes. We supplied all experts, panel members, and attendees with a Worksheet for Proposed Evidence-Based Guidelines with step-by-step directions (these materials are available on the AHA website at http://www.americanheart.org/ECC/index.html). To increase the validity of the results obtained by this evidence-based approach, conference leaders requested help
Emergency Cardiovascular Care Defined
ECC includes all responses necessary to deal with sudden and often life-threatening events affecting the cardiovascular, cerebrovascular, and pulmonary systems. ECC specifically includes
- 1.
Recognition of early warning signs of heart attack and stroke, efforts to prevent complications, reassurance of the victim, and prompt availability of monitoring equipment
- 2.
Provision of immediate BLS at the scene when needed
- 3.
Provision of ACLS at the scene as quickly as possible to defibrillate if necessary and
The Chain of Survival
The highest potential survival rate from cardiac arrest can be achieved only when the following sequence of events occurs as rapidly as possible: (1) recognition of early warning signs, (2) activation of the EMS system, (3) basic CPR, (4) defibrillation, (5) management of the airway and ventilation, and (6) intravenous administration of medications [17]. These events are indispensable for any success of the ECC endeavor. They have been likened to links in a chain. If any link is weak or
The Preventive Cardiology-CPR Paradox
Fully 50% of men and women in western society with serious coronary artery disease (CAD) experience their first signs of the disease in a dramatic way–sudden cardiac arrest. This statement may apply to women as well, but no study has examined this issue in women. The first sign of progressive narrowing of the coronary arteries from the decades-long buildup of intra-arterial plaque can be a rapid sequence of sudden plaque rupture or erosion, platelet adhesion, and an occluding thrombus. The
Final Comments: Have We Achieved ‘International Guidelines’ at the Guidelines 2000 Conference on CPR and ECC?
The authors named the International Guidelines 2000 Conference appropriately. Participants from outside the United States comprised 40% of the total number of people attending. Planning for the new international guidelines included concerted efforts to have international representation at all stages. The Conference did achieve equality in terms of the important roles of primary reviewers and writers, topic experts, and panel moderators. At least 1 US scientist and 1 non-US scientist evaluated
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2018, ResuscitationCitation Excerpt :One of the main functions of ILCOR over the last 25 years has been to review published research evidence periodically to produce an international Consensus on Science with Treatment Recommendations (CoSTR). Since 2000, ILCOR has provided an updated CoSTR every 5 years [2–5] which the ERC has subsequently incorporated into its guidelines [6–8]. In recent years, the scale and pace of new clinical trials and observational studies in resuscitation science has grown exponentially.
Exploring the extent of knowledge of CPR skills among school teachers in Riyadh, KSA
2016, Journal of Taibah University Medical SciencesCitation Excerpt :Even among the teachers who received previous training in our study, not one enrolled in a second course to refresh their memories and improve their skills in performing CPR. In addition, items such as emergency contact numbers, the location of the nearest healthcare centres, and even the location of the first aid kit at school were not familiar to most of the teachers, despite the verdict of international resuscitation councils that the teaching of resuscitation in schools should be regarded as a primary educational strategy to achieve widespread learning of CPR.10 The source of information about CPR was mostly a course taken while studying at the university (29.3%), while television and the internet contribute 24.2% and 18.2%, respectively.
Ian Jacobs - Resuscitation leader, educator and researcher
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