CRP & Defibrillator Access Key to Resuscitation Success Rates

POSTED ON 22 March 2016

QUALITY CPR & DEFIBRILLATOR ACCESS KEY FEATURES IN NEW ANZCOR GUIDELINES

The Australian and New Zealand Committee on Resuscitation have release a range of new guidelines which refine the best practice for resuscitation.

Early defibrillation combined with CPR can improve survival rates to as high as 74% when defibrillation is provided within three minutes of collapse. For every minute that is wasted, the chance of survival decreases 7-10%.

The following guidelines were released on January 13th 2016 which recommend that along with quality and good CPR, reduced time to defibrillation are the highest priorities for increased survival rates in those who have cardiac arrest. When using a defibrillator if the first shock is not successfull and the defibrillator is capable of delivering shocks of higher energy it is reasonable to increase the energey to the maximum available for subsequent shocks. For the comprehesive list of guidelines visit http://resus.org.au/guidelines/.

These guidelines give support for a range of AED's we sell which all provide quick time to shock.

AED Category

In a study* that measured the time to shock defined as the time rescuers entered the room until the time a shock was delivered overall the Lifepak CR Plus was the best performing taking only 93 seconds. As the AED is fully automatic it will deliver a shock automatically, if needed, without the rescuer having to push a button.

AED SHock Success over time

ANZCOR Guideline 6 : Compressions

The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations:

  • 1. All rescuers should perform chest compressions for all persons who are unresponsive and not breathing normally.
  • 2. Interruptions to chest compressions should be minimised.
  • 3. Those who are trained and willing to give rescue breaths do so for all persons who are unresponsive and not breathing normally.

 

ANZCOR Guildelines 7 : External Automated Defibrillation in Basic Life Support

The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations:

 

  • 1. For all who are unresponsive and not breathing normally, chest compressions should be commenced immediately and continued until an AED is applied. The AED should be applied as soon as it becomes available so that a shock can be delivered if necessary.
  • 2. The use of AEDs is recommended to increase survival rates in those who have cardiac arrest.
  • 3. Pads are to be placed to ensure that a shock is delivered on an axis through the heart. Typical pad placement in adults and children is the anterior-lateral position.
  • 4. Although AEDs are extremely safe, rescuers should take care not to touch a person during shock delivery.

 

ANZCOR Guildelines 8 : Cardiopulmonary

The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations:

  • 1. Rescuers must start CPR if the person is unresponsive and not breathing normally.
  • 2. Bystander CPR should be actively encouraged.
  • 3. Compression-to-ventilation ratio be 30:2 for all ages.
  • 4. All rescuers perform chest compressions for all who are not breathing normally. Rescuers who are trained and willing to give rescue breaths are encouraged to do so.
  • 5. Chest compressions should be provided at a rate of approximately 100 - 120 /min.
  • 6. Rescuers should aim to minimise interruptions to chest compressions.

 

ANZCOR Guidelines 11.2 : Protocols for Adult Advanced Life Support

The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations:

  • 1. That the Adult ALS algorithm be used as a tool to manage all adults who require advanced life support.
  • 2. Good quality CPR and reducing time to defibrillation are the highest priorities in resuscitation from sudden cardiac arrest.
  • 3. Rescuers should aim to minimise interruptions to CPR during any ALS intervention.

 

ANZCOR Guidelines 11.4 : Electrical Therapy for Adult Advanced Life Support

The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations:

  • 1. A defibrillation shock is delivered as soon as a defibrillator is available.
  • 2. Paddles or pads are placed on the exposed chest in an anterior-lateral position or an anterior-posterior position.
  • 3. In patients with an ICD or a permanent pacemaker the defibrillator pad/paddle is placed on the chest wall ideally at least 8 cm from the generator position.
  • 4. Self-adhesive defibrillation pads are used for defibrillation.
  • 5. Biphasic waveforms are used for defibrillation.
  • 6. For Monophasic waveforms: the initial energy level for adults is set at maximum (usually 360 Joules) for all shocks.
  • 7. For Biphasic waveforms: the default energy level for adults is set at 200J for all shocks. Other energy levels may be used providing there is relevant clinical data for a specific defibrillator that suggests that an alternative energy level provides adequate shock success (e.g. Usually greater than 90%).
  • 8. If the first shock is not successful and the defibrillator is capable of delivering shocks of higher energy, it is reasonable to increase the energy to the maximum available for subsequent shocks.
  • 9. A single shock strategy is used in patients in cardiac arrest requiring defibrillation for VF or pulseless VT.

 

* Andrew AD, et al. "Automated External Defibrillator Use by Untrained Bystanders: Can the public model work? " Prehistoric Emergency Care. 2004; 8: 284-291.