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Soar J, Maconochie I, Wyckoff MH, et al. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2019 Dec;145:95-150. doi: 10.1016/j.resuscitation.2019.10.016. Epub 2019 Nov 14. (Evidence-based guideline)
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.

Ratings
Discipline Area Score
Intensivist/Critical Care 7 / 7
Public Health 7 / 7
Pediatric Emergency Medicine 7 / 7
Emergency Medicine 6 / 7
Hospital Doctor/Hospitalists 6 / 7
Internal Medicine 6 / 7
Cardiology 6 / 7
Pediatric Hospital Medicine 6 / 7
Pediatric Neonatology 6 / 7
Comments from MORE raters

Cardiology rater

This is the first CPR guideline I have seen which provides a Grade pro approach. As a recommendation, it is better to summarize their recommendation on a separate table which can be easy to read and useful for physicians.

Emergency Medicine rater

The review of existing evidence on cardiac arrest in adults and pediatrics is relatively limited. To sum it up: bystander CPR is good and dispatcher instructions can help more people get bystander CPR. Waiting for EMS to arrive is not good. Supraglottic airways are probably the way to go if an airway is going to be used (and it might be okay to just do BVM; although, particularly in adults, it is often a challenge to ventilate or oxygenate effectively with BVM).

Hospital Doctor/Hospitalists rater

It's good to know that most interventions showed an improvement but it's disappointing that the supporting evidence was high only for epinephrine.

Intensivist/Critical Care rater

This is not disruptive, but a good consensus on available science (not much ...) and a set of recommendations with a large pediatric and NLS portion!

Internal Medicine rater

There is a good overview of current concepts and useful information for the providers.

Pediatric Emergency Medicine rater

It's important for practitioners in the field to know the key changes from the previous guidelines for resuscitation.

Pediatric Emergency Medicine rater

Critical reading.

Pediatric Hospital Medicine rater

Many, but not all, pediatric hospitalists are on the front line of pediatric codes called in their institutions. It is useful to know the basis for much of what is taken as "gospel truth" when taking or renewing PALS and the like. Additionally, it is useful to know what our colleagues in Europe are doing in the area of resuscitation.

Pediatric Hospital Medicine rater

This is a recent update on ALS, including Pediatric and Neonatal resuscitation. There are updates on DA-CPR, ECPR, TTM and Oxygen conc during neonatal resuscitation in pediatric patients.

Pediatric Neonatology rater

This article gives the ILCOR NLS task group's recommendations re: initial oxygen concentration for resuscitation of term and preterm infants and. It reiterates the evidence supporting use of low oxygen concentration for initiating resuscitation is both groups. Additionally, it highlights gaps in evidence and makes recommendations for future research. The other sections of the paper, though not directly relevant to neonatal practice, are useful and interesting to read.

Public Health rater

The article is a must as an update for International Liaison Committee on Resuscitation literature review update. As expected, it focuses on the evidence on all domains of CPR, ECC- BLS, ACLS, Pediatric or adult.
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