New guidelines for cardiovascular emergencies

New guidelines for cardiovascular emergencies with many changes
In emergency situations of the cardiovascular system such as a heart attack, every second counts. In addition, the interplay of lay helpers and acute medicine or emergency services is crucial, according to the latest release from the Charité-Universitätsmedizin Berlin. This was also taken into account in the current revision of the International Guidelines for Cardiovascular Emergency Medicine and Resuscitation, for the German summary of which the cardiologist and emergency physician Professor Dr. med. Martin Möckel of the Berlin Charité was responsible.

Every five years, the international guidelines for cardiovascular emergency medicine and resuscitation are revised. The current revision process under the auspices of the International Liaison Committee on Resuscitation, said Charité medical professionals from around the world. "For professional helpers as well as lay helpers, new standards for cardiopulmonary resuscitation and further emergency assistance are defined against the background of international experience," reports the Berlin Charité.

The new guidelines for cardiovascular emergencies include some changes. (Image: hriana / fotolia.com)

Guidelines for first responders and healthcare professionals
Because every second counts in an emergency and every action is important, the existing resuscitation guidelines are continuously reviewed and adapted to the current state of knowledge. New guidelines for cardiopulmonary resuscitation and cardiovascular medicine are now available that incorporate some changes based on the experience of global specialists. The guidelines serve as the basis for first aid training and include procedures for lay helpers as well as for healthcare professionals, according to the Charité Communication.

As an innovation in the guidelines, the Berlin Charité states the following points:

• The concept introduced in 2010 to begin resuscitation with chest compressions has been confirmed, although a slightly increased frequency of 100 to 120 times per minute is recommended for chest compressions in the case of adult cardiac arrest.
• The primary use of an Automated External Defibrillator (AED) is allowed if it is immediately available.
• Trained lay helpers are to administer the antidote naloxone in an overdose of opioids, so sleep and painkillers.
• In case of cardiac arrest, for which a cardiovascular lesion is suspected, an angiography, ie imaging, of the coronary arteries is considered to be appropriate if it is carried out as an emergency. This can also happen in the unconscious state of the patient and increases the chances of survival.
• Targeted temperature management now recommends a target body temperature of 32 to 36 degrees Celsius in the first 24 hours after a cardiac arrest in patients with persistent spontaneous comatose, instead of the previously recommended cooling down to 32 to 34 degrees Celsius.

Interplay between first-aiders and medical professionals is crucial
According to Professor Möckel, the interplay between laypersons and physicians remains crucial for all the innovations in the guidelines. "Only in the perfect interaction of first-aiders and healthcare professionals can the rescue chain be successful - regardless of whether it is an emergency in the hospital or outside" continues the expert. For this reason, the guidelines recommend differentiated rescue chains inside and outside the clinic for the first time. The omnipresent availability of mobile phones is also taken into account, emphasizes Professor Möckel. "In addition to numerous other details in the resuscitation practice for adults, children and newborns, the new guidelines are also devoted to ethical issues of resuscitation," continued the Berlin Charité. (Fp).