OUT NOW: New and Updated ILCOR 2015 Treatment Recommendations on Cardiopulmonary Resuscitation

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Since the year 2000 the International Liaison Committee on Resuscitation (ILCOR) continues to evaluate all evidence and updates their recommendations in 5-year cycles. The most recent ILCOR 2015 International Consensus Conference was held in Dallas last February and the new treatment recommendation are out now.

Resuscitation remains one of the most challenging situations in health care. Providing basic and advanced cardiac life support gives you the opportunity to virtually safe a patients life but in a very limited period of time. It is an enormous challenge to consider all emerging evidence and pack this into simple and useful guidelines.

It is imperative to for any health care provider to get familiar with the updated guidelines and major changes. Below you can find all relevant links to get the reading going.

The team of BoringEM.org in Canada have provided some excellent infographics to visualise all important changes in the new treatment guidelines since 2010. You should also note that the Canadian Heart & Stroke Association and the American Heart Association have just published the ‘HIGHLIGHTS of the 2015 American Heart Association Guidelines Update for CPR and ECC’, an excellent summary of the new recommendations and changes. So if you can’t find the time to read all of the publication in ‘Circulation’, this will certainly provide all information you need to know.

The links to all infographics can be found on our website HERE
Summary of the Canadian Heart & Stroke Association and the American Heart Association: HIGHLIGHTS of the 2015 American Heart Association Guidelines Update for CPR and ECC

​The original publication in Circulation, October 20, 2015, Volume 132, Issue 16 suppl 1

​ERC and ESICM 2015 Guidelines for Post-Resuscitation Care

​Based on the the 2015 ILCOR treatment recommendations the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have produced these post-resuscitation care guidelines on October the 13th. Recent changes here are the greater emphasis for urgent PCI when indicated, target temperature management at 36°C, prognostic evaluation using a multimodal strategy and an increased emphasis on rehabilitation after survival.

Nolan JP, Resuscitation, October 2015, Pages 202 – 222


Spreading the Word: In Hyperkalemia Ringer’s Lacate is Superior to Normal Saline

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Just recently the discussion came up once again on what sort of infusion should be used in patients with hyperkalemia. To my surprise the idea seems to persist that normal saline (NS) should be used, as this solute does not contain any further potassium. This is a thought in the wrong direction and Pulmcrit made a great statement in 2014 to clarify this myth. The key points are as follows:

Infusing Ringer’s lactate (RL) in a patient with hyperkalemia will actually lower his serum potassium level
Even a solute with twice the potassium concentration of RL (this would be 8mmol/L) would require a vast amount of fluid to create any effect in serum potassium levels
NS has been shown to produce non-anion gap metabolic acidosis, which causes potassium to shift out of cells, thereby increasing potassium levels
RL does not cause any acidosis

Here’s all the background reading including references:

Pulmcrit Myth-busting: RL is safe in hyperkalemia, and is superior to NS

This might also be of interest. Have a very close look on normal saline infusions:

Normal Saline and Acidosis: Is it Really the Salt that Matters?