Author/Editor		Žmavc, Andrej
Title		Ali mednarodne smernice za dodatne postopke oživljanja 2000 zagotavljajo dovolj zunanje masaže srca med oživljanjem
Translated title		Do international guidelines provide sufficient chest compressions during resuscitations
Type		članek
Source		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 8. Zbornik 9. mednarodni simpozij o urgentni medicini; 2002 jun 19-22; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2002
Volume		str. 118-21
Language		slo
Abstract		The 1994 ERC Guidelines had implemented three consecutive electroshocks for the treatment of ventricular fibrillation (VF) while the International Guidelines 2000 restricted resuscitation periods between defibrillations down to one minute until return of spontaneous circulation or termination of CPR. Both recommendations affect the time available for performing chest compressions (CC). In a serie of CPR according to the international guidelines 2000 performed on a manikin (Laerdal ALS skilltrainer 200) the non-CC intervals were measured. ACLS teams consisted of an emergency physician and two emergency technicians. The return of spontaneous circulation was designed to be established 20s after the third defibrillation cycle. At nine simulated resuscitations the average duration of CPR was 357 sec (max 390, min 305). The average duration of the whole non-CC interval was 48,2 % (max 51,7%, min 40,3%) of the complete CPR time (with strictly performed pulse check even 50,2%!). Non-CC interval due to initial assessment and placing the patient into an appropriate position took only 6% (20 sec) of the whole CPR time. Resuscitating a patient being in a cardiac arrest for at least 4 minutes prior to CPR without CC for nearly 3 minutes during the next 6 minutes of CPR might seriously affect the final outcome. The result is achieved at well pre-discussed situation in an almost ideal conditions and by well trained resuscitation teams. It is very unlikely that the real situation out in the field would be the same. The clinical significance of the current international ACLS guidelines concerning ventricular fibrillation therefore urgently need to be evaluated.
Descriptors		RESUSCITATION RESUSCITATION ORDERS HEART MASSAGE ELECTRIC COUNTERSHOCK