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Resuscitation 95 (2015) 81–99

Contents lists available at ScienceDirect

Resuscitation

j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / r e s u s c i t a t i o n

European Resuscitation Council Guidelines for Resuscitation 2015 Section 2. Adult basic life support and automated external defibrillation

Gavin D. Perkins a,b, , Anthony J. Handley c , Rudolph W. Koster d , Maaret Castrén e , Michael A. Smyth a,f , Theresa Olasveengen g , Koenraad G. Monsieurs h,i , Violetta Raffay j , Jan-Thorsten Gräsner k , Volker Wenzel l , Giuseppe Ristagno m , Jasmeet Soar n , on behalf of the Adult basic life support and automated external defibrillation section Collaborators1

a Warwick Medical School, University of Warwick, Coventry, UK

b Critical Care Unit, Heart of England NHS Foundation Trust, Birmingham, UK c Hadstock, Cambridge, UK

d Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands

e Department of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Finland f West Midlands Ambulance Service NHS Foundation Trust, Dudley, UK

g Norwegian National Advisory Unit on Prehospital Emergency Medicine and Department of Anesthesiology, Oslo University Hospital, Oslo, Norway h Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

i Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium j Municipal Institute for Emergency Medicine Novi Sad, Novi Sad, Serbia

k Department of Anaesthesia and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Kiel, Germany l Department of Anesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Austria

m Department of Cardiovascular Research, IRCCS-Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy n Anaesthesia and Intensive Care Medicine, Southmead Hospital, Bristol, UK

Introduction

This chapter contains guidance on the techniques used during the initial resuscitation of an adult cardiac arrest victim. This includes basic life support (BLS: airway, breathing and circulation support without the use of equipment other than a protective device) and the use of an automated external defibrillator (AED). Simple techniques used in the management of choking (foreign body airway obstruction) are also included. Guidelines for the use of manual defibrillators and starting in-hospital resuscitation are found in the section Advanced Life Support Chapter.1 A summary of the recovery position is included, with further information provided in the First Aid Chapter.2

The guidelines are based on the ILCOR 2015 Consensus on Science and Treatment Recommendations (CoSTR) for BLS/AED.3 The ILCOR review focused on 23 key topics leading to 32 treatment recommendations in the domains of early access and cardiac arrest prevention, early, high-quality CPR, and early defibrillation. For these ERC guidelines the ILCOR recommendations were supplemented by focused literature reviews undertaken by Writing Group members in areas not reviewed by ILCOR. The writing group were

Corresponding author.

E-mail address: g.d.perkins@warwick.ac.uk (G.D. Perkins).

1 The members of the Adult basic life support and automated external defibrillation section Collaborators are listed in the Collaborators section.

cognisant of the costs and potential confusion created by changing guidance from 2010, and therefore sought to limit changes to those judged to be essential and supported by new evidence. Guidelines were drafted by Writing Group members, then reviewed by the full writing group and national resuscitation councils before final approval by the ERC Board.

Summary of changes since the ERC 2010 guidelines

Guidelines 2015 highlights the critical importance of the interactions between the emergency medical dispatcher, the bystander who provides CPR and the timely deployment of an automated external defibrillator. An effective, co-ordinated community response that draws these elements together is key to improving survival from out-of-hospital cardiac arrest (Fig. 2.1).

The emergency medical dispatcher plays an important role in the early diagnosis of cardiac arrest, the provision of dispatcherassisted CPR (also known as telephone CPR), and the location and dispatch of an automated external defibrillator. The sooner the emergency services are called, the earlier appropriate treatment can be initiated and supported.

The knowledge, skills and confidence of bystanders will vary according to the circumstances, of the arrest, level of training and prior experience.

The ERC recommends that the bystander who is trained and able should assess the collapsed victim rapidly to determine if the victim

http://dx.doi.org/10.1016/j.resuscitation.2015.07.015

0300-9572/© 2015 European Resuscitation Council. Published by Elsevier Ireland Ltd. All rights reserved.

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