Seit mehreren Jahren hat das International Liaison Committee on Resuscitation (ILCOR) zusätzlich zu den alle 5 Jahre veröffentlichten Leitlinien ein jährliches Update eingeführt, in dem ausgewählte Themen außerhalb des 5-Jahres-Rhythmus analysiert und bewertet werden [1]. Diese Updates erscheinen regelhaft zum Ende eines jeden Jahres und erschienen im Dezember 2023. Die in diesem Beitrag betrachteten Fragestellungen nehmen Bezug auf die Veröffentlichung aus 2022 sowie weitere Artikel aus dem Jahr 2022 und 2023 [2]
[3]
[4]
[5].
Abstract
Perfect, uninterrupted basic life support (BLS) is the key for successful cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA). Time plays an important role in the treatment of OHCA. This applies both to the time until the start of BLS and the reduction of all pauses during resuscitation, especially chest compressions. In 2022, the rate of bystander-CPR showed an absolute increase of 4% compared to previous years. The bystander-CPR rate is currently above 50%. Compared to OHCA in adults, cardiac arrest in children is rare in Germany. In the period from 2007 to 2021, the incidence was 3.08 per 100000 children. In addition, the etiology in children varies depending on the age group. While hypoxia is often the cause of circulatory arrest in younger children, trauma and drowning accidents are the main causes in school-age children. Different additional diagnostic and therapeutic strategies have been evaluated over the last years. Point-of-care ultrasound
during resuscitation should only be performed by experienced users. Interrupting chest compressions and thus prolonging the no-flow phases must be avoided. Double sequential external defibrillation after the third shock can successfully terminate refractory ventricular fibrillation. While further studies are needed, emergency medical systems should train their teams to avoid complications. In refractory OHCA, extracorporeal CPR should be considered. In the case of in-hospital cannulation, immediate transport should be weighed against impaired chest compression quality. Therefore, transportation under CPR is only beneficial if there is an indication for further treatment.
Schlüsselwörter
Reanimation - Resuscitation Academy - Überlebenskette - Herz-Kreislauf-Stillstand
Keywords
Resuscitation Academy - out-of-hospital cardiac arrest - chain of survival
