From basic to advanced life support.
Resuscitation is a word that arouses feelings of fear and dread in many of us. Thanks to support from NZNO and the New Zealand Resuscitation Council (NZRC), I was privileged to attend the 8th International Spark of Life conference in Perth in April, Looking at the Latest research and expert opinion surrounding resuscitation issues.
The conference was hosted by the Australian Resuscitation Council (ARC), which has recently worked with the NZRC to produce joint guidelines. We heard from a wide range of speakers and international experts, including members of the International Liaison Committee on Resuscitation. Every five years, this group reviews current research and sets resuscitation guidelines internationally.
A neonatal satellite meeting was held on the first day, with topics ranging from putting neonatal guidelines into practice, preserving neonatal organs during resuscitation, and resuscitating the mother and foetus during pregnancy.
The second and third days covered basic to advanced Life support. The problem of emergency health providers often working in "silos" was mentioned several times throughout the conference. It would be very beneficial, for example, if intensive care unit staff and neonatologists had a better understanding of how resuscitations occur in pre-hospital settings, and vice versa. This would help art emergency personnel appreciate other professional roles and work towards good neurological outcomes and survivals to discharge.
Continuous chest compressions was an ongoing emphasis, with the precordial thump now advised only to be undertaken with monitored in-hospital cardiac arrest. Good basic Life support was also examined, with the importance of ongoing education to the public to "do something, not nothing", during a collapse or cardiac arrest.
In paediatric resuscitations, some shockable rhythms are going unrecognised. Timing of the administration of adrenaline remains debatable worldwide. The use of end tidal expired CO2 to monitor quality of CPR was stated, as well as the usual indication of return of spontaneous circulation. Joules for defibrillation may be the maximum joules of the machine for adults, depending on the unit available for shockable rhythms.
There were also presentations on hyperoxaemia and its potential harmful effects. The pre-hospital intubation debate remains contentious, with increasing use of alternative airways, such as the Laryngeal mask airway, and the encouragement of rapid sequence induction for trauma patients. Needle cricothyroidotomies (for emergency breathing) are often unsuccessful--higher success rates are occurring with straight cricothyroidotomy. Another point made was that pre-hospital thrombotysis should be administered if a patient is more than four hours away from a cardiac catheterisation Laboratory.
The next Australasian area conference on resuscitation will be in Auckland next April, hosted by the NZRC. Check out www.nzrc.org.nz for further information as it comes to hand.
Report by NZNO representative on the NZRC, Sheryl Eden
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|Title Annotation:||CONFERENCE REPORTS|
|Publication:||Kai Tiaki: Nursing New Zealand|
|Date:||Jun 1, 2011|
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