Recent discussions
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Daniela MEDEIROS
I agree starting with a lower oxygen concentration (21-30%) for preterms with more than 32 weeks
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Angela Viau
In my country there are no personnel trained to use this POCUS technology, there are few doctors who know how to use it, in addition, in my point of view a lot of time is lost in resuscitation and can damage brain injuries.
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marije hogeveen
Can you provide us with the search strategie used so we can check whether relevant new literature has been published for the ERC updates?
thank you in advance
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Deepa Santhosh
Nice topic
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Clément Derkenne
Although this item (BLS 2212) has been updated on November 11th, 2024, It seems surprising not to see in this topic the de Graaf studies (10.1016/j.resuscitation.2021.01.003.) and ours (10.1016/j.resuscitation.2024.110292). Both looked at technologies that analyze electrical rhythms during chest compressions. Both algorithms used these technologies either to extend the duration of CPR to 4 min if a non-shockable rhythm was detected (de Graaf et al.) or to shorten the duration of CPR to 1 min if a shockable rhythm was detected (Derkenne et al.). I might make sense that ILCOR positions it-self on these innovative solutions.
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Marcos Almeida
we don’t have acess to videolarincoscope in my city. I never used this type, but i belive that this can be useful and bring benefits in nicu.
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Janet Bray
Thank you for your comment. There is another PICOST that addresses checking for circulation during CPR. Janet Bray (BLS Chair)
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Remi Garceau
Good day,
I was wondering if you have any clinical data that would indicate if the resuscitation that occured, if the providers was trained with QCPR feed back or not. We are telling groups like the Heart and stroke foundation that this should be impleted and yet, they are imposing it in the instructor guidelines.
Would it not be more concluent to have the QCPR feedback mandatory on all health care provider AED or manual AED? This would have a direct impact not on a dummy, but on a real person.
A provider is trained once per year with a QCPR, but all resuscitation could be done with a QCPR device and improve the quality on a real life person.
Thanks
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Anwar Adil Mithwani
Video laryngoscopy provides an enhanced and magnified view of vocal cards on a screen which is particularly helpful in difficult intubation.This method shows intubation process in real time and guide the tranee.process may take longer due to need to focus and manipulate the blade, superior in visualizing the airway anomalies (craniofacial abnormalties)
Lower rates of mucosal trauma.
Less effective in emergency situation
Traditional Laryngoscopy requires direct line of sight which can be challenging sometimes in Neonates.,success rates depends upon training and needs more experiences. process is quicker for experienced.In less experienced person high risk of trauma.
Often preferred in emergency to save life.
In conclusion : Choice between VL & TL for neonatal intubation depends upon provider"s expertise ,avaiable resources and clinical scenario. video laryngoscopy is good for teaching,training and managing difficult airways.
TL remains indispensable in low source settings and emergencies .
An integrated approach using VL as a training adjunct and TL as a fallback, might provide the best outcomes in neonatal airway management.
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Sheldon Cheskes
The use of a Good Practice Statement (GPS) to recommend anterior-lateral pads as a starting pad position for CPR providers trained in manual defibrillation seems inappropriate given the lack of new evidence supporting this pad position compared to an anterior-posterior pad position. In general “Panels should consider making good practice statements when they have high confidence that indirect evidence undoubtedly supports net benefit and when, in addition, it would be an onerous and unproductive exercise and thus a poor use of the panel’s limited resources to collect this evidence”1. In the case of anterior-lateral vs anterior-posterior initial pad position for defibrillation, I do not believe such indirect evidence exists. The statement specifically, notes a preference for the anterior-lateral position on the assumption of optimizing placement speed while minimizing interruptions to chest compressions. Regarding the assumption of optimizing placement speed one only looks at the recent trials assessing the impact of IO or IV in OHCA where the assumption was that IO would be faster than IV vascular access.2,3 The trials both demonstrate that such assumptions are often erroneous when placed under the scrutiny of a randomized controlled trial. As well, in defibrillation one must balance speed vs defibrillation efficacy which is directly related to current applied to the myocardium. While the study from Lupton et al. is observational in nature, it does raise the possibility of increase shock efficacy for pads place in an initial anterior-posterior position for patients in ventricular fibrillation/pulseless ventricular tachyardia.4 Regarding the assumption of minimizing interruptions in chest compressions, it was noted in the DOSE VF RCT that regardless of whether the patient received standard, vector change or double sequential external defibrillation, there was no difference in CPR quality, all of which were guideline compliant regardless of randomization arm.5 Given these uncertainties it seems inappropriate to make a GPS supporting one pad position over another for initial pad placement when the required indirect evidence does not exist. Given no new evidence exists, a recommendation supporting either pad position similar to the ILCOR statement of 2021 seems more appropriate (It is reasonable to place pads on the exposed chest in an anterior-lateral position. An acceptable alternative position is anterior-posterior).6
References above available upon request