Recent discussions
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Виктория Антонова
Many NICU transport teams are not permitted to perform UVCs. IO is now their go to device for resuscitation use. IO placement is easily completed rapidly compared to attempting UVC access. -
Виктория Антонова
When comparing humeral IO to IV placement I have found that medication is just as fast by humeral IO. -
Виктория Антонова
In our state, Ceará, we practice umbilical catheterization instead of the intraosseous pathway. -
Виктория Антонова
Why is there a change in recommendations in the absence of any new evidence?? There is a substantial difference in adult and paediatric resuscitation but this was not reflected in the justification and treatment recommendations at all. The clinical evidence in not new norr sufficient for the change of recommendation in my opinion. The value of chest compressions in CA secondary to asphyxia where blood is already almost completely deprived of oxygen is debatable at the best (most cases of paediatric CAs). Also, for the same pathophysiological reason, the ERC started to recommend in 2015 the initial 5 rescue breaths not only for paediatric resuscitation but also for drowning (in the special circumstances section). -
Виктория Антонова
We train the rescue service, anaesthesiologists and obstetricians in the use of an umbilical vein access with a blunt hollow cannula. Although this is not a central venous access, but you get an easy and fast venous access. -
Виктория Антонова
The Royal Dutch Dental Association (Koninklijke Maatschappij voor Tandheelkunde) launched in 2019 a public campaign on what to do with avulsed permanent tooth. The striking message is: "is rinse the tooth, place it back and instead of going to the emergency or go directly to the dentist." Striking because the ILCOR 'Treatment Recommendations' in the systematic review assumes storing a tooth in Hank's Balanced Salt solution (HBSS), propolis, ORS or milk and no evidence-remarks about the possibility of temporarily replacing after cleaning (with water). What seems to be an effective and fast way to offer a tooth some survival rate. Although the review stated that “making these recommendations, we recognize that survival of an avulsed tooth requires that it must be replanted as soon as possible, but this procedure may not be possible in the first aid setting.” A large contrast to the mentioned public campaign! -
ILCOR Staff
The error has been corrected. Thanks for pointing this out -
Виктория Антонова
In My opinion this recomendation reflects the reality in most of the NICU's in Germany. The intraosseus line for drug Administration is meanwhile well known for pediatric patients even as for adult patients in cardiac arrest and it is an oportunity even for newborns. But the smaller the patient is the more difficult is the correct placement of the needle and the greater is the risk for having severe undesireable adverse effects. So the personel has to be trained verry good in the handling of this tool when it is used in the resuscitation of newborns. On the other hand the umbilical vein is relatively easy to determine an it is a verry fast procedure to put an vascular canula inside it just for a view centimeters to use it as a emergency access. Even this procedure has to be trained carefully, but it's easy to learn. So i think you are right to give this recomendation even so there is poor evidence for it. On the other hand -
Виктория Антонова
We used the term "suction-based airway clearance device" to describe a number of commercially available devices that are specifically designed and intended to be used for the removal of foreign body airway obstructions. This term was not intended to include the use of suction with a suction catheter (whether mechanical or manual) as currently used by EMS, first responders, and in the hospital setting. Thank you for the comment. We will reflect on whether this term requires further clarification in the final document. -
Виктория Антонова
It is very strange to change a previous COSTR recommendation without any new evidence nor consulting the paediatric taskforce in this? This makes one thoroughly question the validity of the Grade process. When looking at the EtD table a clear difference between adult and child is made but for some reason this is not very well reflected in the TR and justification. In my opninion the clinical evidence provided (all older than 2015) is not sufficient to warrent such a recommendation, knowing