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1. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Author

Berg, Katherine M., Bray, Janet E., Ng, Kee-Chong, Liley, Helen G., Greif, Robert, Carlson, Jestin N., Morley, Peter T., Drennan, Ian R., Smyth, Michael, Scholefield, Barnaby R., Weiner, Gary M., Cheng, Adam, Djärv, Therese, Abelairas-Gómez, Cristian, Acworth, Jason, Andersen, Lars W., Atkins, Dianne L., Berry, David C., Bhanji, Farhan, Bierens, Joost, Bittencourt Couto, Thomaz, Borra, Vere, Böttiger, Bernd W., Bradley, Richard N., Breckwoldt, Jan, Cassan, Pascal, Chang, Wei-Tien, Charlton, Nathan P., Chung, Sung Phil, Considine, Julie, Costa-Nobre, Daniela T., Couper, Keith, Dainty, Katie N., Dassanayake, Vihara, Davis, Peter G., Dawson, Jennifer A., de Almeida, Maria Fernanda, De Caen, Allan R., Deakin, Charles D., Dicker, Bridget, Douma, Matthew J., Eastwood, Kathryn, El-Naggar, Walid, Fabres, Jorge G., Fawke, Joe, Fijacko, Nino, Finn, Judith C., Flores, Gustavo E., Foglia, Elizabeth E., Folke, Fredrik, Gilfoyle, Elaine, Goolsby, Craig A., Granfeldt, Asger, Guerguerian, Anne-Marie, Guinsburg, Ruth, Hatanaka, Tetsuo, Hirsch, Karen G., Holmberg, Mathias J., Hosono, Shigeharu, Hsieh, Ming-Ju, Hsu, Cindy H., Ikeyama, Takanari, Isayama, Tetsuya, Johnson, Nicholas J., Kapadia, Vishal S., Kawakami, Mandira Daripa, Kim, Han-Suk, Kleinman, Monica E., Kloeck, David A., Kudenchuk, Peter, Kule, Amy, Kurosawa, Hiroshi, Lagina, Anthony T., Lauridsen, Kasper G., Lavonas, Eric J., Lee, Henry C., Lin, Yiqun, Lockey, Andrew S., Macneil, Finlay, Maconochie, Ian K., Madar, R. John, Malta Hansen, Carolina, Masterson, Siobhan, Matsuyama, Tasuku, McKinlay, Christopher J.D., Meyran, Daniel, Monnelly, Vix, Nadkarni, Vinay, Nakwa, Firdose L., Nation, Kevin J., Nehme, Ziad, Nemeth, Michael, Neumar, Robert W., Nicholson, Tonia, Nikolaou, Nikolaos, Nishiyama, Chika, Norii, Tatsuya, Nuthall, Gabrielle A., Ohshimo, Shinchiro, Olasveengen, Theresa M., Ong, Yong-Kwang Gene, Orkin, Aaron M., Parr, Michael J., Patocka, Catherine, Perkins, Gavin D., Perlman, Jeffrey M., Rabi, Yacov, Raitt, James, Ramachandran, Shalini, Ramaswamy, Viraraghavan V., Raymond, Tia T., Reis, Amelia G., Reynolds, Joshua C., Ristagno, Giuseppe, Rodriguez-Nunez, Antonio, Roehr, Charles C., Rüdiger, Mario, Sakamoto, Tetsuya, Sandroni, Claudio, Sawyer, Taylor L., Schexnayder, Steve M., Schmölzer, Georg M., Schnaubelt, Sebastian, Semeraro, Federico, Singletary, Eunice M., Skrifvars, Markus B., Smith, Christopher M., Soar, Jasmeet, Stassen, Willem, Sugiura, Takahiro, Tijssen, Janice A., Topjian, Alexis A., Trevisanuto, Daniele, Vaillancourt, Christian, Wyckoff, Myra H., Wyllie, Jonathan P., Yang, Chih-Wei, Yeung, Joyce, Zelop, Carolyn M., Zideman, David A., Nolan, Jerry P., Barcala-Furelos, Roberto, Beerman, Stephen B., Castrén, Maaret, Chong, ShuLing, Claesson, Andreas, Dunne, Cody L., Ersdal, Hege L., Finan, Emer, Fuerch, Janene, Fukuda, Tatsuma, Ganesan, Saptharishi Lalgudi, Gately, Callum, Gray, Seth, Halamek, Louis P., Hoover, Amber V., Kollander, Louise, Kamlin, C. Omar, Koo, Mirjam, Li, Lei, Leone, Tina A., Mecrow, s, Montgomery, William, Ristau, Patrick, Jayashree, Muralidharan, Quek, Bin Huey, Schmidt, Andrew, Scquizzato, Tommaso, Seesink, Jeroen, Sempsrott, Justin, Shah, Birju A., Strand, Marya L., Szpilman, David, Szyld, Edgardo, Thio, Marta, Thom, Ogilvie, Tobin, Joshua M., Udaeta, Enrique, Webber, Jonathon, Webster, Hannah K., Wellsford, Michelle, and Yamada, Nicole K.

Abstract

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.

Published
2023
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2. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Author

Wyckoff, Myra H., Greif, Robert, Morley, Peter T., Ng, Kee-Chong, Olasveengen, Theresa M., Singletary, Eunice M., Soar, Jasmeet, Cheng, Adam, Drennan, Ian R., Liley, Helen G., Scholefield, Barnaby R., Smyth, Michael A., Welsford, Michelle, Zideman, David A., Acworth, Jason, Aickin, Richard, Andersen, Lars W., Atkins, Diane, Berry, David C., Bhanji, Farhan, Bierens, Joost, Borra, Vere, Böttiger, Bernd W., Bradley, Richard N., Bray, Janet E., Breckwoldt, Jan, Callaway, Clifton W., Carlson, Jestin N., Cassan, Pascal, Castrén, Maaret, Chang, Wei-Tien, Charlton, Nathan P., Chung, Sung Phil, Considine, Julie, Costa-Nobre, Daniela T., Couper, Keith, Couto, Thomaz Bittencourt, Dainty, Katie N., Davis, Peter G., de Almeida, Maria Fernanda, de Caen, Allan R., Deakin, Charles D., Djärv, Therese, Donnino, Michael W., Douma, Matthew J., Duff, Jonathan P., Dunne, Cody L., Eastwood, Kathryn, El-Naggar, Walid, Fabres, Jorge G., Fawke, Joe, Finn, Judith, Foglia, Elizabeth E., Folke, Fredrik, Gilfoyle, Elaine, Goolsby, Craig A., Granfeldt, Asger, Guerguerian, Anne-Marie, Guinsburg, Ruth, Hirsch, Karen G., Holmberg, Mathias J., Hosono, Shigeharu, Hsieh, Ming-Ju, Hsu, Cindy H., Ikeyama, Takanari, Isayama, Tetsuya, Johnson, Nicholas J., Kapadia, Vishal S., Kawakami, Mandira Daripa, Kim, Han-Suk, Kleinman, Monica, Kloeck, David A., Kudenchuk, Peter J., Lagina, Anthony T., Lauridsen, Kasper G., Lavonas, Eric J., Lee, Henry C., Lin, Yiqun (Jeffrey), Lockey, Andrew S., Maconochie, Ian K., Madar, R. John, Malta Hansen, Carolina, Masterson, Siobhan, Matsuyama, Tasuku, McKinlay, Christopher J.D., Meyran, Daniel, Morgan, Patrick, Morrison, Laurie J., Nadkarni, Vinay, Nakwa, Firdose L., Nation, Kevin J., Nehme, Ziad, Nemeth, Michael, Neumar, Robert W., Nicholson, Tonia, Nikolaou, Nikolaos, Nishiyama, Chika, Norii, Tatsuya, Nuthall, Gabrielle A., O’Neill, Brian J., Ong, Yong-Kwang Gene, Orkin, Aaron M., Paiva, Edison F., Parr, Michael J., Patocka, Catherine, Pellegrino, Jeffrey L., Perkins, Gavin D., Perlman, Jeffrey M., Rabi, Yacov, Reis, Amelia G., Reynolds, Joshua C., Ristagno, Giuseppe, Rodriguez-Nunez, Antonio, Roehr, Charles C., Rüdiger, Mario, Sakamoto, Tetsuya, Sandroni, Claudio, Sawyer, Taylor L., Schexnayder, Steve M., Schmölzer, Georg M., Schnaubelt, Sebastian, Semeraro, Federico, Skrifvars, Markus B., Smith, Christopher M., Sugiura, Takahiro, Tijssen, Janice A., Trevisanuto, Daniele, Van de Voorde, Patrick, Wang, Tzong-Luen, Weiner, Gary M., Wyllie, Jonathan P., Yang, Chih-Wei, Yeung, Joyce, Nolan, Jerry P., Berg, Katherine M., Burdick, Madeline C., Cartledge, Susie, Dawson, Jennifer A., Elgohary, Moustafa M., Ersdal, Hege L., Finan, Emer, Flaatten, Hilde I., Flores, Gustavo E., Fuerch, Janene, Garg, Rakesh, Gately, Callum, Goh, Mark, Halamek, Louis P., Handley, Anthony J., Hatanaka, Tetsuo, Hoover, Amber, Issa, Mohmoud, Johnson, Samantha, Kamlin, C. Omar, Ko, Ying-Chih, Kule, Amy, Leone, Tina A., MacKenzie, Ella, Macneil, Finlay, Montgomery, William, O’Dochartaigh, Domhnall, Ohshimo, Shinichiro, Palazzo, Francesco Stefano, Picard, Christopher, Quek, Bin Huey, Raitt, James, Ramaswamy, Viraraghavan V., Scapigliati, Andrea, Shah, Birju A., Stewart, Craig, Strand, Marya L., Szyld, Edgardo, Thio, Marta, Topjian, Alexis A., Udaeta, Enrique, Vaillancourt, Christian, Wetsch, Wolfgang A., Wigginton, Jane, Yamada, Nicole K., Yao, Sarah, Zace, Drieda, and Zelop, Carolyn M.

Abstract

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.

Published
2022
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3. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Author

Wyckoff, Myra H., Singletary, Eunice M., Soar, Jasmeet, Olasveengen, Theresa M., Greif, Robert, Liley, Helen G., Zideman, David, Bhanji, Farhan, Andersen, Lars W., Avis, Suzanne R., Aziz, Khalid, Bendall, Jason C., Berry, David C., Borra, Vere, Böttiger, Bernd W., Bradley, Richard, Bray, Janet E., Breckwoldt, Jan, Carlson, Jestin N., Cassan, Pascal, Castrén, Maaret, Chang, Wei-Tien, Charlton, Nathan P., Cheng, Adam, Chung, Sung Phil, Considine, Julie, Costa-Nobre, Daniela T., Couper, Keith, Dainty, Katie N., Davis, Peter G., de Almeida, Maria Fernanda, de Caen, Allan R., de Paiva, Edison F., Deakin, Charles D., Djärv, Therese, Douma, Matthew J., Drennan, Ian R., Duff, Jonathan P., Eastwood, Kathryn J., El-Naggar, Walid, Epstein, Jonathan L., Escalante, Raffo, Fabres, Jorge G., Fawke, Joe, Finn, Judith C., Foglia, Elizabeth E., Folke, Fredrik, Freeman, Karoline, Gilfoyle, Elaine, Goolsby, Craig A., Grove, Amy, Guinsburg, Ruth, Hatanaka, Tetsuo, Hazinski, Mary Fran, Heriot, George S., Hirsch, Karen G., Holmberg, Mathias J., Hosono, Shigeharu, Hsieh, Ming-Ju, Hung, Kevin K.C., Hsu, Cindy H., Ikeyama, Takanari, Isayama, Tetsuya, Kapadia, Vishal S., Kawakami, Mandira Daripa, Kim, Han-Suk, Kloeck, David A., Kudenchuk, Peter J., Lagina, Anthony T., Lauridsen, Kasper G., Lavonas, Eric J., Lockey, Andrew S., Malta Hansen, Carolina, Markenson, David, Matsuyama, Tasuku, McKinlay, Christopher J.D., Mehrabian, Amin, Merchant, Raina M., Meyran, Daniel, Morley, Peter T., Morrison, Laurie J., Nation, Kevin J., Nemeth, Michael, Neumar, Robert W., Nicholson, Tonia, Niermeyer, Susan, Nikolaou, Nikolaos, Nishiyama, Chika, O’Neil, Brian J., Orkin, Aaron M., Osemeke, Osokogu, Parr, Michael J., Patocka, Catherine, Pellegrino, Jeffrey L., Perkins, Gavin D., Perlman, Jeffrey M., Rabi, Yacov, Reynolds, Joshua C., Ristagno, Giuseppe, Roehr, Charles C., Sakamoto, Tetsuya, Sandroni, Claudio, Sawyer, Taylor, Schmölzer, Georg M., Schnaubelt, Sebastian, Semeraro, Federico, Skrifvars, Markus B., Smith, Christopher M., Smyth, Michael A., Soll, Roger F., Sugiura, Takahiro, Taylor-Phillips, Sian, Trevisanuto, Daniele, Vaillancourt, Christian, Wang, Tzong-Luen, Weiner, Gary M., Welsford, Michelle, Wigginton, Jane, Wyllie, Jonathan P., Yeung, Joyce, Nolan, Jerry P., and Berg, Katherine M.

Abstract

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

Published
2022
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4. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Author

Soar, Jasmeet, Maconochie, Ian, Wyckoff, Myra H., Olasveengen, Theresa M., Singletary, Eunice M., Greif, Robert, Aickin, Richard, Bhanji, Farhan, Donnino, Michael W., Mancini, Mary E., Wyllie, Jonathan P., Zideman, David, Andersen, Lars W., Atkins, Dianne L., Aziz, Khalid, Bendall, Jason, Berg, Katherine M., Berry, David C., Bigham, Blair L., Bingham, Robert, Couto, Thomaz Bittencourt, Böttiger, Bernd W., Borra, Vere, Bray, Janet E., Breckwoldt, Jan, Brooks, Steven C., Buick, Jason, Callaway, Clifton W., Carlson, Jestin N., Cassan, Pascal, Castrén, Maaret, Chang, Wei-Tien, Charlton, Nathan P., Cheng, Adam, Chung, Sung Phil, Considine, Julie, Couper, Keith, Dainty, Katie N., Dawson, Jennifer Anne, de Almeida, Maria Fernanda, de Caen, Allan R., Deakin, Charles D., Drennan, Ian R., Duff, Jonathan P., Epstein, Jonathan L., Escalante, Raffo, Gazmuri, Raúl J., Gilfoyle, Elaine, Granfeldt, Asger, Guerguerian, Anne-Marie, Guinsburg, Ruth, Hatanaka, Tetsuo, Holmberg, Mathias J., Hood, Natalie, Hosono, Shigeharu, Hsieh, Ming-Ju, Isayama, Tetsuya, Iwami, Taku, Jensen, Jan L., Kapadia, Vishal, Kim, Han-Suk, Kleinman, Monica E., Kudenchuk, Peter J., Lang, Eddy, Lavonas, Eric, Liley, Helen, Lim, Swee Han, Lockey, Andrew, Lofgren, Bo, Ma, Matthew Huei-Ming, Markenson, David, Meaney, Peter A., Meyran, Daniel, Mildenhall, Lindsay, Monsieurs, Koenraad G., Montgomery, William, Morley, Peter T., Morrison, Laurie J., Nadkarni, Vinay M., Nation, Kevin, Neumar, Robert W., Ng, Kee-Chong, Nicholson, Tonia, Nikolaou, Nikolaos, Nishiyama, Chika, Nuthall, Gabrielle, Ohshimo, Shinichiro, Okamoto, Deems, O’Neil, Brian, Yong-Kwang Ong, Gene, Paiva, Edison F., Parr, Michael, Pellegrino, Jeffrey L., Perkins, Gavin D., Perlman, Jeffrey, Rabi, Yacov, Reis, Amelia, Reynolds, Joshua C., Ristagno, Giuseppe, Roehr, Charles C., Sakamoto, Tetsuya, Sandroni, Claudio, Schexnayder, Stephen M., Scholefield, Barnaby R., Shimizu, Naoki, Skrifvars, Markus B., Smyth, Michael A., Stanton, David, Swain, Janel, Szyld, Edgardo, Tijssen, Janice, Travers, Andrew, Trevisanuto, Daniele, Vaillancourt, Christian, Van de Voorde, Patrick, Velaphi, Sithembiso, Wang, Tzong-Luen, Weiner, Gary, Welsford, Michelle, Woodin, Jeff A., Yeung, Joyce, Nolan, Jerry P., and Fran Hazinski, Mary

Abstract

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

Published
2019
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5. 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary

Author

Soar, Jasmeet, Donnino, Michael W., Maconochie, Ian, Aickin, Richard, Atkins, Dianne L., Andersen, Lars W., Berg, Katherine M., Bingham, Robert, Böttiger, Bernd W., Callaway, Clifton W., Couper, Keith, Couto, Thomaz Bittencourt, de Caen, Allan R., Deakin, Charles D., Drennan, Ian R., Guerguerian, Anne-Marie, Lavonas, Eric J., Meaney, Peter A., Nadkarni, Vinay M., Neumar, Robert W., Ng, Kee-Chong, Nicholson, Tonia C., Nuthall, Gabrielle A., Ohshimo, Shinichiro, O’Neil, Brian J., Ong, Gene Yong-Kwang, Paiva, Edison F., Parr, Michael J., Reis, Amelia G., Reynolds, Joshua C., Ristagno, Giuseppe, Sandroni, Claudio, Schexnayder, Stephen M., Scholefield, Barnaby R., Shimizu, Naoki, Tijssen, Janice A., Van de Voorde, Patrick, Wang, Tzong-Luen, Welsford, Michelle, Hazinski, Mary Fran, Nolan, Jerry P., and Morley, Peter T.

Abstract

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the second annual summary of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations that includes the most recent cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation. This summary addresses the role of antiarrhythmic drugs in adults and children and includes the Advanced Life Support Task Force and Pediatric Task Force consensus statements, which summarize the most recent published evidence and an assessment of the quality of the evidence based on Grading of Recommendations, Assessment, Development, and Evaluation criteria. The statements include consensus treatment recommendations approved by members of the relevant task forces. Insights into the deliberations of each task force are provided in the Values and Preferences and Task Force Insights sections. Finally, the task force members have listed the top knowledge gaps for further research.

Published
2018
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7. Abstract 149: Double Sequential External Defibrillation in Refractory Ventricular Fibrillation: The Dose VF Pilot Randomized Controlled Trial

Author

Cheskes, Sheldon, Dorian, Paul, McLeod, Shelley, Scales, Damon, Pinto, Ruxandra, Turner, Linda, Morrison, Laurie J, Drennan, Ian R, and Verbeek, Richard

Abstract

Background:Despite significant advances in resuscitation efforts, there are some patients who remain in ventricular fibrillation (VF) after multiple defibrillation attempts during out-of-hospital cardiac arrest (OHCA). Double sequential external defibrillation (DSED) and vector change defibrillation (VC) have been proposed as alternate therapeutic strategies for OHCA patients in shock-refractory VF.Objective:To determine the feasibility, safety and sample size required for a larger, multicentered, 3-arm, cluster randomized controlled trial (RCT) with 2 crossovers comparing DSED or VC to standard defibrillation (control group) for OHCA patients presenting in shock-refractory VF.Methods:We conducted a pilot cluster randomized controlled trial with crossover including all consecutive treated adult OHCA patients who presented in VF and received a minimum of three successive shocks. In addition to standard cardiac arrest care, each EMS agency was randomly assigned to provide standard defibrillation (control), DSED, or VC, followed by crossover to an alternate defibrillation strategy after 6 months.Results:Prior to the launch of the trial, 2,500 paramedics received in-person training in the techniques of DSED and VC defibrillation using a combination of didactic, video and simulated scenarios. Between March 2018 and June 2019, 113 patients were enrolled in 4 Canadian EMS agencies, with zero missed cases. Monthly enrollment varied from 1 to 6 cases per agency. With respect to feasibility, 96% of cases were compliant with the study protocol, and only five (4.4%) cases received a defibrillation strategy that differed from the allocation schedule. There were no reported cases of defibrillator malfunction, no concerns expressed by paramedics, patients, families, or ED staff about the trial, and no reported cases of skin burns or difficulty with pad placement.Conclusions:Findings from our pilot implementation trial suggest the DOSE VF protocol is feasible and safe. The results of this internal pilot trial will allow us to calculate a sample size for a definitive multicenter cluster RCT with crossovers to determine if these alternate defibrillation strategies for OHCA shock refractory VF will impact patient-centered, clinical outcomes.

Published
2019
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