![]() The AHA makes a moderate-strength recommendation for the use of bag-mask ventilation over endotracheal tube ventilation. Based on limited data, the AHA CPR Guidelines 2020 reviewers conclude that rates of survival to hospital discharge and survival with good neurologic outcome are similar between pediatric patients treated with BVM ventilation and those treated with endotracheal tube ventilation. They also could not recommend one type of advanced airway device as clearly superior to another device. At that time, the AHA stated the strength and quality of the evidence prohibited a recommendation for or against the use of an advanced airway during the pediatric resuscitation attempt. Last year, the AHA addressed whether EMS providers should provide bag-mask ventilation with or without an advanced airway. One recommendation specifically addressed to prehospital care involves the decision to use an advanced airway during pediatric resuscitation. Limited data also supported the AHA CPR Guidelines 2020 reaffirmation of the moderate-strength recommendation for compression rates of 100-120 compressions per minute.Īdvanced airway management. The AHA makes a moderate-strength recommendation for chest compressions depths of one-third the anterior-posterior diameter of the chest for infants and children, based on limited data. As with the adult patient, the AHA CPR Guidelines 2020 do not alter previous compression depth and rate recommendations for pediatric patients. ![]() Pediatric basic and advanced life supportĬhest compression rate and depth. Changes to the algorithm now depict epinephrine administration as appropriate after the second defibrillation attempt for shock refractory rhythms. The AHA CPR Guidelines 2020 reaffirm that position as a weak recommendation based on limited data. The 2019 AHA focused update recommended epinephrine administration for shockable rhythms after initial defibrillation attempts have failed. The AHA Guidelines 2015 made no recommendation on when resuscitation teams should administer epinephrine to patients with shockable rhythms. The AHA CPR Guidelines 2020 now strengthen that recommendation with moderate quality evidence based on limited data. With respect to timing, the AHA Guidelines 2015 made a weak recommendation that resuscitation teams consider giving epinephrine as soon as feasible when the patient presents with a non-shockable rhythm. The AHA CPR Guidelines 2020 strongly reaffirm that position, based on moderate quality evidence. Last year, a focused update on the use of epinephrine in cardiac arrest concluded that resuscitation teams should continue to administer epinephrine for the treatment of cardiac arrest in adult patients at 3-5 minute intervals for the duration of the resuscitation attempt. The use of epinephrine in cardiac arrest. When IV attempts are unsuccessful or access is not feasible, there is a weaker recommendation for the teams to consider establishing an IO. Based on moderate quality evidence not involving a randomized trial, the AHA believes it is reasonable for resuscitation teams to first attempt IV access. Unfortunately, a rigorous review of the evidence questions the efficacy of the IO route when compared to the IV route. Recently however, many EMS agencies began moving away from initial IV attempts during resuscitation in favor of intraosseous access. Historically, venous cannulation was the primary access strategy. Another interesting recommendation involves the manner in which resuscitation teams gain access to the vascular space for medication administration. Because of this level and quality of evidence, the strongest recommendation the AHA can make in 2020 is that resuscitation team mays consider the strategy. Current published evidence on the usefulness of this strategy for shock-refractory episodes of ventricular fibrillation or pulseless ventricular tachycardia remains limited and weak. Although many EMS agencies around the country include double sequential defibrillation in their treatment protocols, previous AHA guidelines were silent on the subject. ![]() In contrast, there is a moderate-strength for compression rates of 100-120 compressions per minute, based on moderate quality evidence.ĭouble sequential defibrillation. The AHA continues to make a strong recommendation for chest compressions of at least two inches but not more than 2.4 inches in the adult patient, based on moderate quality evidence. While not altering current recommendations for compression depth and rate in adult patients, the AHA CPR Guidelines 2020 reaffirm the importance of chest compression quality in achieving improved survival measures. Over the past decade or so, researchers have directed considerable resources into using research to guide resuscitation education practices as well as driving system of care changes to help optimize survival.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |